Healthcare Provider Details

I. General information

NPI: 1962385351
Provider Name (Legal Business Name): LAURA J STRAIT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2025
Last Update Date: 07/31/2025
Certification Date: 07/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3033 ORCHARD VISTA DR SE STE 307
GRAND RAPIDS MI
49546-7077
US

IV. Provider business mailing address

3303 ORCHARD VISTA DR SE STE 307
GRAND RAPIDS MI
49546-7777
US

V. Phone/Fax

Practice location:
  • Phone: 616-438-9902
  • Fax:
Mailing address:
  • Phone: 616-438-9902
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number4704234247
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code163WG0600X
TaxonomyGerontology Registered Nurse
License Number4704234247
License Number StateMI
# 3
Primary TaxonomyN
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number4704234247
License Number StateMI
# 4
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704234247
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: