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NPI Code Detail

MEDICARE: JENNIFER LYNN LANCZAK

MEDICARE: JENNIFER LYNN LANCZAK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP0808XPsychiatric/Mental Health Registered Nurse4704226642MI
2363LP0808XPsychiatric/Mental Health Nurse Practitioner4704226642MI

General Provider Information

NPI Number : 1184482622
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER LYNN LANCZAK
Provider Business Mailing Address
First Line : 800 S WASHINGTON AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48601-2551
Country : US
Telephone Number : 989-907-8000
Fax Number :
Provider Business Practice Location Address
First Line : 800 S WASHINGTON AVE
Second Line :
City : SAGINAW
State : MI
Zip : 48601-2551
Country : US
Telephone Number : 989-907-8000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/11/2024
Last Update Date : 04/07/2026

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Directions to “ JENNIFER LYNN LANCZAK ” Practice Location

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