Provider Demographics
NPI:1255863619
Name:VANGRONINGEN, LAUREN (RN)
Entity Type:Individual
Prefix:MRS
First Name:LAUREN
Middle Name:
Last Name:VANGRONINGEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 CARLTON AVE SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49506-1653
Mailing Address - Country:US
Mailing Address - Phone:616-648-7728
Mailing Address - Fax:
Practice Address - Street 1:227 CARLTON AVE SE
Practice Address - Street 2:
Practice Address - City:GRAND RAPIDS
Practice Address - State:MI
Practice Address - Zip Code:49506-1653
Practice Address - Country:US
Practice Address - Phone:616-648-7728
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704325303163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse