Provider Demographics
NPI:1649411273
Name:DOYLE-MCFARLAND, LISA (RD NHA)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:
Last Name:DOYLE-MCFARLAND
Suffix:
Gender:F
Credentials:RD NHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14203 RICK DR
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-2935
Mailing Address - Country:US
Mailing Address - Phone:586-247-3513
Mailing Address - Fax:586-247-5101
Practice Address - Street 1:14203 RICK DR
Practice Address - Street 2:
Practice Address - City:SHELBY TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48315-2935
Practice Address - Country:US
Practice Address - Phone:586-247-3513
Practice Address - Fax:586-247-5101
Is Sole Proprietor?:No
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI803798133V00000X
MI4801013400171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No171M00000XOther Service ProvidersCase Manager/Care Coordinator