Healthcare Provider Details

I. General information

NPI: 1396192472
Provider Name (Legal Business Name): LAUREN VOCKE DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/19/2016
Last Update Date: 01/15/2024
Certification Date: 01/15/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3101 DISCOVERY DR STE 400
LANSING MI
48910-8546
US

IV. Provider business mailing address

3101 DISCOVERY DR STE 400
LANSING MI
48910-8546
US

V. Phone/Fax

Practice location:
  • Phone: 517-975-3750
  • Fax: 517-975-3755
Mailing address:
  • Phone: 517-975-3750
  • Fax: 517-975-3755

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number5151011707
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number5101025108
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: