Provider Demographics
NPI:1114565629
Name:ZULAUF, LIZA LYNN (FNP)
Entity Type:Individual
Prefix:
First Name:LIZA
Middle Name:LYNN
Last Name:ZULAUF
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2006 10TH ST
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6751
Mailing Address - Country:US
Mailing Address - Phone:989-450-8642
Mailing Address - Fax:
Practice Address - Street 1:248 WASHINGTON AVE STE A
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48708-5848
Practice Address - Country:US
Practice Address - Phone:989-249-8940
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-16
Last Update Date:2020-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704279064363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily