Individual
LAURIE SUE NASTAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCCA
Contact information
Practice address
14600 KING RD, SUITE D, RIVERVIEW, MI 48193-7952
(734) 486-4444
(734) 486-5555
Mailing address
14600 KING RD, SUITE D, RIVERVIEW, MI 48193-7952
(734) 486-4444
(734) 486-5555
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
1601000272
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4189127
—
MI
01
—
5352130
AETNA HMO AND MC
—
01
—
540H001354
BCBSM
MI
01
—
640H977751
BCBSM
MI
Enumeration date
09/07/2006
Last updated
01/07/2009
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