Individual
MR. JEFFREY RAYNER LAPENNAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
19100 W 7 MILE RD, DETROIT, MI 48219-2758
(313) 533-5002
Mailing address
19100 W 7 MILE RD, DETROIT, MI 48219-2758
(313) 533-5002
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704394815
MI
Other
Enumeration date
08/01/2023
Last updated
08/01/2023
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