Provider Demographics
NPI:1184417594
Name:MORISSEAU, YVONNE MONA-LISA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:YVONNE
Middle Name:MONA-LISA
Last Name:MORISSEAU
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5574 ABINGTON
Mailing Address - Street 2:
Mailing Address - City:WEST BLOOMFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48322-4013
Mailing Address - Country:US
Mailing Address - Phone:574-520-2886
Mailing Address - Fax:
Practice Address - Street 1:5574 ABINGTON
Practice Address - Street 2:
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48322-4013
Practice Address - Country:US
Practice Address - Phone:574-520-2886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-28
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704286263NSA250B9363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology