Healthcare Provider Details

I. General information

NPI: 1629155163
Provider Name (Legal Business Name): LAURA E LEPPINK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LAURA E GAVRIL NP

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 11/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 E WARWICK DR
ALMA MI
48801-1014
US

IV. Provider business mailing address

6201 N SHERIDAN RD
EDMORE MI
48829-9726
US

V. Phone/Fax

Practice location:
  • Phone: 989-463-1101
  • Fax:
Mailing address:
  • Phone: 517-881-5310
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number4704220033
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: