Healthcare Provider Details

I. General information

NPI: 1528978350
Provider Name (Legal Business Name): LORI ROSENDALE RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/11/2026
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

333 DAHLIA DR
LANSING MI
48911-3789
US

IV. Provider business mailing address

6340 TIMBERLAND DR
DIMONDALE MI
48821-9755
US

V. Phone/Fax

Practice location:
  • Phone: 517-755-5541
  • Fax: 517-755-1129
Mailing address:
  • Phone: 517-242-8770
  • Fax: 517-755-1129

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number4704266195
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: