Healthcare Provider Details

I. General information

NPI: 1508723636
Provider Name (Legal Business Name): JENNIFER HOLDCRAFT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2026
Last Update Date: 01/09/2026
Certification Date: 01/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 COLLINS RD
LANSING MI
48910-8394
US

IV. Provider business mailing address

4415 WILLOUGHBY RD
HOLT MI
48842-9752
US

V. Phone/Fax

Practice location:
  • Phone: 517-490-0673
  • Fax:
Mailing address:
  • Phone: 517-490-0673
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302031153
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: