Individual
NICHOLAS JAMES LANNEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2750 E BELTLINE AVE NE FL 3, GRAND RAPIDS, MI 49525-8614
(616) 267-7104
Mailing address
100 MICHIGAN ST NE # MC845, GRAND RAPIDS, MI 49503-2560
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
4301502075
MI
Other
Enumeration date
06/15/2015
Last updated
02/18/2021
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