Provider Demographics
NPI:1780225441
Name:MONCRIEFF-AUSTIN, LIJA TURAIDA (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:LIJA
Middle Name:TURAIDA
Last Name:MONCRIEFF-AUSTIN
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 E PENINSULA CT
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48371-3669
Mailing Address - Country:US
Mailing Address - Phone:248-515-6742
Mailing Address - Fax:
Practice Address - Street 1:500 E PENINSULA CT
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:MI
Practice Address - Zip Code:48371-3669
Practice Address - Country:US
Practice Address - Phone:248-515-6742
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-03
Last Update Date:2019-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239950363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily