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General NPI Number Information
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NPI Number | 1467639682
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Entity Type | Individual
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Provider Name | LUNDI ANN CORNELL LAC, RN
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Gender | Female
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Dates
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Enumeration Date | 01/30/2008
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Last Update Date | 04/29/2025
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Provider Practice Location Address
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Address Line | 1883 W MONROE RD
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City | SAINT LOUIS
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State | MI
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Zip | 48880-8702
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Country | US
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Telephone | 406-850-1009
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Fax |
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Provider Business Mailing Address
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Address Line | 7961 ISLAND CT
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City | STANWOOD
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State | MI
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Zip | 49346-8920
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Country | US
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Telephone | 406-850-1009
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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 | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 5401000240
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License Number State | MI
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