Provider Demographics
NPI:1578038188
Name:HARDING, LIISA MARIE (FNP-BC)
Entity type:Individual
Prefix:
First Name:LIISA
Middle Name:MARIE
Last Name:HARDING
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5285 ANTHONY WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48202-3947
Mailing Address - Country:US
Mailing Address - Phone:313-577-5041
Mailing Address - Fax:313-577-9581
Practice Address - Street 1:5285 ANTHONY WAYNE DR
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48202-3947
Practice Address - Country:US
Practice Address - Phone:313-577-5041
Practice Address - Fax:313-577-9581
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2025-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704213823363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily