Stacy Lou Carlisle

NPI #1417757485 in Wayne, Michigan

Provider Information

NPI Number: 1417757485
Entity Type: Individual
Name: Stacy Lou Carlisle
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Registered Nurse
Enumeration Date: Mar 18, 2025
Last Updated: Mar 18, 2025

Practice Location

Address: 5049 HARRISON ST
City: Wayne
State: Michigan
ZIP Code: 48184-2220
Phone: (313) 971-2319

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Registered Nurse	163W00000X	Primary

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