Individual
MRS. LAREE C DEPIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1400 MERCY DR STE 100, MUSKEGON, MI 49444-1833
(231) 733-1326
(231) 733-5212
Mailing address
1400 MERCY DR STE 100, MUSKEGON, MI 49444-1833
(231) 733-1326
(231) 733-5212
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704229397
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0876504
BCBS PIN
MI
01
—
430D110990
BCBS GROUP BILL PIN
MI
05
—
4718235
—
MI
01
—
CE1952
RAILROAD GROUP
MI
01
—
LD229397
BCBS LICENSE NUMBER
MI
01
—
P00183821
RAILROAD MEDICARE
MI
Enumeration date
03/17/2006
Last updated
04/19/2024
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