Individual
MRS. LORIE A PENDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
5777 W MAPLE RD, WEST BLOOMFIELD, MI 48322-2267
(248) 932-9223
(248) 932-8641
Mailing address
5874 SHAUN RD, WEST BLOOMFIELD, MI 48322-1624
(248) 737-5197
(248) 737-5197
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
L-313608
MI
363LW0102X
Women's Health Nurse Practitioner
4704233617
MI
367A00000X
Advanced Practice Midwife
Primary
4704233617
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000494119
ANTHEM BCBS
—
05
—
200843290
—
IN
Enumeration date
11/28/2006
Last updated
01/11/2024
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