Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Lisa Sonia Maclellan, FNP-C

Individual provider Nurse Practitioner · NPI 1629637921

Lisa Sonia Maclellan, FNP-C is a Nurse Practitioner in Petoskey, Michigan. Qualified in 2018, 8 years ago. Practices with Theoria Medical, a 342-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Michigan.

Years since qualifying
8
Licensed in
MI
In the registry since
2019
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

3250 Woods Way Ste 5
Petoskey, MI 49770-7628
Phone: (231) 881-9700
Fax: (231) 881-9698
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 5200 W Beeman Rd, Empire, MI 49630-9739 — (561) 275-9798

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 4704242836 (MI)

Record details

NPI number1629637921
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorYes
NPI enumeratedJune 10, 2019
Last updated in NPPESAugust 27, 2019

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Theoria Medical — 342 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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