Provider Demographics
NPI:1114253978
Name:JEAN-FRANCOIS, LAURA VASQUEZ (NP)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:VASQUEZ
Last Name:JEAN-FRANCOIS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:LAURA
Other - Middle Name:VASQUES
Other - Last Name:HEILIG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:2270 JOLLY OAK RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-3542
Mailing Address - Country:US
Mailing Address - Phone:517-349-6140
Mailing Address - Fax:517-349-6216
Practice Address - Street 1:2270 JOLLY OAK RD
Practice Address - Street 2:SUITE 1
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-3542
Practice Address - Country:US
Practice Address - Phone:517-349-6140
Practice Address - Fax:517-349-6216
Is Sole Proprietor?:No
Enumeration Date:2009-10-28
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704239591363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1057818OtherMCLAREN HEALTH PLAN-MEDICAID
MI200000024345OtherPHP FAMILYCARE
MI0N55170020OtherMEDICARE PLUS BLUE
MI1057818OtherMCLAREN HEALTH ADVANTAGE
MI1057818OtherMCLAREN HEALTH PLAN-COMMERCIAL
MI5008709330OtherBLUE CROSS BLUE SHIELD OF MICHIGAN
MI9068517OtherAETNA
MI200000024345OtherPHP COMMERCIAL
MIN55170020Medicare PIN