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General NPI Number Information
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NPI Number | 1184096331
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Entity Type | Individual
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Provider Name | SHELLY LERCH
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Gender | Female
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Dates
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Enumeration Date | 10/28/2015
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Last Update Date | 10/16/2025
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Provider Practice Location Address
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Address Line | 500 BARFIELD DR
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City | HASTINGS
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State | MI
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Zip | 49058-9018
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Country | US
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Telephone | 269-948-8041
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Fax | 269-948-9319
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Provider Business Mailing Address
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Address Line | 3248 VANDEVER AVE
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City | PEKIN
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State | IL
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Zip | 61554-6257
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 2024030511
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2024030511
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License Number State | MI
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Taxonomy #3
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Taxonomy Code | 364SP0809X
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Taxonomy Name | Adult Psychiatric/Mental Health Clinical Nurse Specialist
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License Number | 2024030511
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License Number State | MI
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