1922141753 NPI number — MS. JANICE MARIE CAIE-LAWRENCE ARNP

Table of content: MS. JANICE MARIE CAIE-LAWRENCE ARNP (NPI 1922141753)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922141753 NPI number — MS. JANICE MARIE CAIE-LAWRENCE ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
CAIE-LAWRENCE
Provider First Name:
JANICE
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1922141753
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/13/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
8052 ODONNELL DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
GROSSE ILE
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
48138-1132
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
734-676-7315
Provider Business Mailing Address Fax Number:
734-676-1663

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
8052 ODONNELL DR
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
GROSSE ILE
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48138-1132
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
734-676-7315
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363LA2200X , with the licence number:  4704119118 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1871645309 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1396839981 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1144371279 , issued by the state of ( MI ) . This identifiers is of the category "MEDICAID".




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