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Individual

MS. LAURA KAY LENTZ

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
1215 FULTON ST E, GRAND RAPIDS, MI 49503-3849
(616) 742-0351
(616) 742-0370
Mailing address
1215 FULTON ST E, GRAND RAPIDS, MI 49503-3849
(616) 742-0351
(616) 740-0370

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
4703041414
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
4703041414
LPN LIENCE
MI
Enumeration date
06/18/2019
Last updated
06/18/2019
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