Provider Demographics
NPI:1437448552
Name:LUBINSK, NANCI LYNNE (BA)
Entity Type:Individual
Prefix:MRS
First Name:NANCI
Middle Name:LYNNE
Last Name:LUBINSK
Suffix:
Gender:F
Credentials:BA
Other - Prefix:MISS
Other - First Name:NANCI
Other - Middle Name:LYNNE
Other - Last Name:VAN KAMPEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:14861 BLAIR ST
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49424-8493
Mailing Address - Country:US
Mailing Address - Phone:616-836-2601
Mailing Address - Fax:
Practice Address - Street 1:14861 BLAIR ST
Practice Address - Street 2:
Practice Address - City:HOLLAND
Practice Address - State:MI
Practice Address - Zip Code:49424
Practice Address - Country:US
Practice Address - Phone:616-836-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-29
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIAF700355378311ZA0620X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311ZA0620XNursing & Custodial Care FacilitiesCustodial Care FacilityAdult Care Home
No171M00000XOther Service ProvidersCase Manager/Care Coordinator