Healthcare Provider Details

I. General information

NPI: 1841104213
Provider Name (Legal Business Name): MS. ADRIENNE KATHLEEN CRIM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2026
Last Update Date: 10/01/2026
Certification Date: 10/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3475 BELLE CHASE WAY
LANSING MI
48911-4252
US

IV. Provider business mailing address

412 N SHIAWASSEE ST
BANCROFT MI
48414-7732
US

V. Phone/Fax

Practice location:
  • Phone: 517-744-7389
  • Fax:
Mailing address:
  • Phone: 810-444-1541
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number6401223614
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: