Provider Demographics
NPI:1295932911
Name:LAKIN, DARLENE KIM (RN)
Entity type:Individual
Prefix:
First Name:DARLENE
Middle Name:KIM
Last Name:LAKIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:DARLENE
Other - Middle Name:KIM
Other - Last Name:WRIGHT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:1728 FOREST RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-4799
Mailing Address - Country:US
Mailing Address - Phone:231-631-8423
Mailing Address - Fax:
Practice Address - Street 1:6100 US 31 NORTH
Practice Address - Street 2:
Practice Address - City:WILLIAMBURG
Practice Address - State:MI
Practice Address - Zip Code:49690
Practice Address - Country:US
Practice Address - Phone:231-938-5983
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
MI4704214456163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse