Individual
LORI ANN BOOMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP
Contact information
Practice address
100 N ROLAND ST, MC BAIN, MI 49657-9683
(231) 825-8101
(231) 825-8104
Mailing address
100 N ROLAND ST, MC BAIN, MI 49657-9683
(231) 825-8101
(231) 825-8104
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704168055
MI
Other
Enumeration date
07/29/2005
Last updated
10/13/2020
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