Active NPI
Laura M Brisboe, CNP
- Family Nurse Practitioner
- East Lansing, MI
National Provider Identifier
1396884722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 4704177648
- Practice address
- 463 E Circle Dr
East Lansing, MI 48824-7500 - Phone
- (517) 884-6546
- Fax
- (517) 432-9460
- NPI assigned
- Feb 5, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 4704177648 | MI | Primary |
Addresses
Primary practice location
463 E Circle Dr
East Lansing, MI 48824-7500
Mailing address
804 Service Rd Ste A109B
East Lansing, MI 48824-7015
Phone (517) 353-4911
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396884722 | Medicaid | MI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Nurse Practitioner, Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4704177648 | MI | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623024000000",
"number": "1396884722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "804 SERVICE RD STE A109B",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488247015",
"telephone_number": "517-353-4911",
"fax_number": "517-432-3928"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "463 E CIRCLE DR",
"city": "EAST LANSING",
"state": "MI",
"postal_code": "488247500",
"telephone_number": "517-884-6546",
"fax_number": "517-432-9460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRISBOE",
"first_name": "LAURA",
"middle_name": "M",
"credential": "CNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-05",
"last_updated": "2021-06-07",
"certification_date": "2021-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MI",
"license": "4704177648",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1396884722",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in East Lansing, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.