Individual
LAUREN FANION
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Mailing address
3111 ELECTRIC AVE, PORT HURON, MI 48060-8127
(810) 985-8900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704346693
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
4704346693
MI
Other
Enumeration date
01/30/2020
Last updated
10/10/2023
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