Individual
JAIMIE L FAST
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5135 S PENNSYLVANIA AVE, LANSING, MI 48911-4002
(517) 220-7546
Mailing address
3810 CENTRAL PIKE, HERMITAGE, TN 37076-3494
(815) 744-8554
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
145422
IA
363LF0000X
Family Nurse Practitioner
Primary
4704337446
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
145422
RN LICENSE
IA
01
—
A156281
ARNP LICENSE
IA
Enumeration date
05/28/2020
Last updated
11/18/2022
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