Individual
LAUREN G CHISOLM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1500 E MEDICAL CENTER DRIVE, 9TH FLOOR CS MOTT CHILDRENS HOSPITAL, ANN ARBOR, MI 48109-4256
(734) 763-5302
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704260681
MI
363LN0000X
Neonatal Nurse Practitioner
4704260681
MI
Other
Enumeration date
08/14/2014
Last updated
09/19/2014
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