Laura Mervenne

Individual provider Active NPI Licensed Practical Nurse · Coopersville, MI

NPI 1962267906 · NPPES record last updated Feb 19, 2024

Key facts

NPI
1962267906
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
4703096249 (MI)
Practice address
623 Birkdale CT
Coopersville, MI 49404-9668
Phone
(616) 460-0133
NPI assigned
Feb 19, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4703096249MIMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 4703096249 MI Yes

Addresses

Primary practice location

623 Birkdale CT
Coopersville, MI 49404-9668

Mailing address

623 Birkdale CT
Coopersville, MI 49404-9668

Other providers in Coopersville, MI

All providers in Coopersville, MI · Licensed Practical Nurse in Michigan

Sources for this page

Verify at the official NPI Registry.