Provider Demographics
NPI:1043417785
Name:SYLVAIN, CLARICE ANDERSON (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:CLARICE
Middle Name:ANDERSON
Last Name:SYLVAIN
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2886 BARCLAY WAY
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-9455
Mailing Address - Country:US
Mailing Address - Phone:734-327-4835
Mailing Address - Fax:
Practice Address - Street 1:ST. JOSEPH MERCY HOSPITAL
Practice Address - Street 2:5301 E. HURON RIVER DRIVE
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48106-0995
Practice Address - Country:US
Practice Address - Phone:734-712-4214
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704136622163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant