Lesa Renee Comerzan, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

4703117514 Issued in MI

Practice address

882 Plum Park Dr
Monroe, MI 48161-9675

Phone

(734) 755-8890

NPI assigned

Jun 28, 2018

Last updated

Jun 28, 2018By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lesa Renee Pongracz Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1530144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530144000000",
    "number": "1417442716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "882 PLUM PARK DR",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619675",
            "telephone_number": "734-755-8890"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "882 PLUM PARK DR",
            "city": "MONROE",
            "state": "MI",
            "postal_code": "481619675",
            "telephone_number": "734-755-8890"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COMERZAN",
        "first_name": "LESA",
        "middle_name": "RENEE",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-28",
        "last_updated": "2018-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703117514",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF MICHIGAN",
            "identifier": "4703117514",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LESA",
            "last_name": "PONGRACZ",
            "middle_name": "RENEE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Diane Collins, RD
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• Jennifer L Combest
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• Jose Ricardo Compean, M.D.
• Complete Ketamine Inc (Complete Ketamine & Wellness)
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• Licensed Practical Nurse in Monroe, MI
• Providers in Monroe, MI by specialty
• Licensed Practical Nurse in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.