Provider Demographics
NPI:1023279825
Name:BRASHER, LISA ANN (RN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:ANN
Last Name:BRASHER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2772 ROLLIN HWY
Mailing Address - Street 2:
Mailing Address - City:HUDSON
Mailing Address - State:MI
Mailing Address - Zip Code:49247-9723
Mailing Address - Country:US
Mailing Address - Phone:517-547-5992
Mailing Address - Fax:
Practice Address - Street 1:1040 S WINTER ST
Practice Address - Street 2:SUITE 1022
Practice Address - City:ADRIAN
Practice Address - State:MI
Practice Address - Zip Code:49221-3876
Practice Address - Country:US
Practice Address - Phone:517-263-8905
Practice Address - Fax:517-265-8237
Is Sole Proprietor?:No
Enumeration Date:2008-06-24
Last Update Date:2008-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704146829163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse