Individual
LAUREN ELIZABETH COLLAVINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18101 OAKWOOD BLVD, DEARBORN, MI 48124-4089
(313) 982-5045
Mailing address
60 HALTINER ST, RIVER ROUGE, MI 48218-1259
(313) 971-9888
(313) 971-9888
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
4704302808
MI
363LF0000X
Family Nurse Practitioner
4704302808
MI
Other
Enumeration date
04/12/2019
Last updated
09/18/2024
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