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General NPI Number Information
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NPI Number | 1205753688
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Entity Type | Individual
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Provider Name | LEANNE RANAE DIPARVINE
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Gender | Female
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Dates
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Enumeration Date | 07/06/2026
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Last Update Date | 07/06/2026
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Provider Practice Location Address
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Address Line | 400 N INGALLS ST
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City | ANN ARBOR
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State | MI
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Zip | 48109-2003
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Country | US
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Telephone | 219-616-8447
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Fax |
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Provider Business Mailing Address
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Address Line | 15306 CAMBRIDGE DR
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City | FRASER
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State | MI
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Zip | 48026-2364
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Country | US
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Telephone | 219-616-8447
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 4704321389
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License Number State | MI
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