Healthcare Provider Details

I. General information

NPI: 1780104356
Provider Name (Legal Business Name): LAURA MARIE SYKES NNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2017
Last Update Date: 06/23/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1215 E. MICHIGAN AAVE
LANSING MI
48909
US

IV. Provider business mailing address

PO BOX 99
DANSVILLE MI
48819-0099
US

V. Phone/Fax

Practice location:
  • Phone: 517-364-4520
  • Fax:
Mailing address:
  • Phone: 517-881-3887
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number4704234701
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: