Healthcare Provider Details

I. General information

NPI: 1407790157
Provider Name (Legal Business Name): KELSEY LEE LESSARD ND
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/15/2026
Last Update Date: 04/15/2026
Certification Date: 04/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3368 BELTLINE CT NE
GRAND RAPIDS MI
49525-9480
US

IV. Provider business mailing address

1411 NORFOLK AVE
GRAND BLANC MI
48439-5173
US

V. Phone/Fax

Practice location:
  • Phone: 616-899-9447
  • Fax:
Mailing address:
  • Phone: 810-287-7169
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1167
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: