Healthcare Provider Details

I. General information

NPI: 1720699481
Provider Name (Legal Business Name): LAURIE ANNE KUZNER RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2020
Last Update Date: 10/29/2025
Certification Date: 10/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4050 E 12 MILE RD
WARREN MI
48092-2534
US

IV. Provider business mailing address

4050 E 12 MILE RD
WARREN MI
48092-2534
US

V. Phone/Fax

Practice location:
  • Phone: 586-578-0220
  • Fax: 586-578-0225
Mailing address:
  • Phone: 586-578-0220
  • Fax: 586-578-0225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number5302026902
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: