Provider Demographics
NPI:1578319109
Name:ESPER, LAUREN DANIELLE (FNP)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:DANIELLE
Last Name:ESPER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:DANIELLE
Other - Last Name:MARTIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3337 BRITTON RD
Mailing Address - Street 2:
Mailing Address - City:PERRY
Mailing Address - State:MI
Mailing Address - Zip Code:48872-9706
Mailing Address - Country:US
Mailing Address - Phone:517-625-3004
Mailing Address - Fax:517-625-5001
Practice Address - Street 1:3337 BRITTON RD
Practice Address - Street 2:
Practice Address - City:PERRY
Practice Address - State:MI
Practice Address - Zip Code:48872-9706
Practice Address - Country:US
Practice Address - Phone:517-625-3004
Practice Address - Fax:517-625-5001
Is Sole Proprietor?:No
Enumeration Date:2024-04-25
Last Update Date:2024-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704375095363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1578319109Medicaid