Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Lisa Provenzano, NP

Individual provider Nurse Practitioner · NPI 1609051135

Lisa Provenzano, NP is a Nurse Practitioner in Bloomfield Hills, Michigan. Qualified in 1990, 36 years ago. Practices with Neuro Pain Consultants PC, a 21-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
36
Licensed in
MI
In the registry since
2008
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

359 Enterprise CT Spc B
Bloomfield Hills, MI 48302-1055
Phone: (248) 751-7246
Fax: (248) 418-2311
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704150069 (MI)

Record details

NPI number1609051135
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedJanuary 3, 2008
Last updated in NPPESMay 23, 2023
Certification dateMay 23, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Neuro Pain Consultants Pc — 21 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

Other providers in Bloomfield Hills