Healthcare Provider Details

I. General information

NPI: 1770492910
Provider Name (Legal Business Name): KERRI BUCHANAN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3119 STONELEIGH DR
LANSING MI
48910-3739
US

IV. Provider business mailing address

5681 WOODSTOCK DR
LANSING MI
48917-1445
US

V. Phone/Fax

Practice location:
  • Phone: 517-755-5337
  • Fax:
Mailing address:
  • Phone: 517-388-1845
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14055124
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: