Healthcare Provider Details

I. General information

NPI: 1972467363
Provider Name (Legal Business Name): LAURA ELIZABETH POND DNP, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/11/2025
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4230 COPPER RIDGE DR BLDG E
TRAVERSE CITY MI
49684-7256
US

IV. Provider business mailing address

50413 MONROE ST
CANTON MI
48188-6601
US

V. Phone/Fax

Practice location:
  • Phone: 231-935-6382
  • Fax:
Mailing address:
  • Phone: 248-231-4011
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number4704343778
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: