Provider Demographics
NPI:1770904229
Name:STRIEGLE, LISA MARIE (APRN)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:MARIE
Last Name:STRIEGLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1676 VIEWPOND DR SE STE 100A
Mailing Address - Street 2:
Mailing Address - City:KENTWOOD
Mailing Address - State:MI
Mailing Address - Zip Code:49508-4994
Mailing Address - Country:US
Mailing Address - Phone:616-455-9450
Mailing Address - Fax:616-455-5221
Practice Address - Street 1:1676 VIEWPOND DR SE STE 100A
Practice Address - Street 2:
Practice Address - City:KENTWOOD
Practice Address - State:MI
Practice Address - Zip Code:49508-4994
Practice Address - Country:US
Practice Address - Phone:616-455-9450
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704205244363LF0000X, 363LA2200X, 363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1770904229Medicaid
MI4704205244OtherMICHIGAN LICENSE