Healthcare Provider Details

I. General information

NPI: 1265929889
Provider Name (Legal Business Name): LAUREN ANNE LOVERING RAWIE NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2018
Last Update Date: 11/04/2024
Certification Date: 06/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5333 MCAULEY DRIVE SUITE 6109
YPSILANTI MI
48197
US

IV. Provider business mailing address

24 FRANK LLOYD WRIGHT DRIVE SUITE J2000
ANN ARBOR MI
48105
US

V. Phone/Fax

Practice location:
  • Phone: 248-858-6104
  • Fax: 248-858-6115
Mailing address:
  • Phone: 734-747-6766
  • Fax: 734-222-3100

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704397827
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: