Healthcare Provider Details

I. General information

NPI: 1619355641
Provider Name (Legal Business Name): MEGHAN STERNEMANN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2015
Last Update Date: 05/11/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2682 E GRAND RIVER AVE
EAST LANSING MI
48823-5608
US

IV. Provider business mailing address

PO BOX 13008
LANSING MI
48901-3008
US

V. Phone/Fax

Practice location:
  • Phone: 517-333-6562
  • Fax: 517-333-6563
Mailing address:
  • Phone: 517-364-6253
  • Fax: 517-364-6204

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number4704279610
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: