Individual
WANDA LOWERY-LAMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
4201 SAINT ANTOINE ST, DETROIT, MI 48201-2153
(952) 442-9770
(952) 442-3630
Mailing address
DEPT 203401, PO BOX 67000, DETROIT, MI 48267-0001
(952) 442-9770
(952) 442-3630
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704171189
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104300201
—
MI
01
—
WL171189
BLUE CROSS OF MI
MI
Enumeration date
12/23/2005
Last updated
10/07/2010
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