Provider Demographics
NPI:1740989292
Name:ANDERSON, LAURYN ELIZABETH (CPD)
Entity type:Individual
Prefix:MS
First Name:LAURYN
Middle Name:ELIZABETH
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:CPD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:207 RUDDIMAN DR
Mailing Address - Street 2:
Mailing Address - City:NORTH MUSKEGON
Mailing Address - State:MI
Mailing Address - Zip Code:49445-2731
Mailing Address - Country:US
Mailing Address - Phone:231-749-8487
Mailing Address - Fax:
Practice Address - Street 1:207 RUDDIMAN DR
Practice Address - Street 2:
Practice Address - City:NORTH MUSKEGON
Practice Address - State:MI
Practice Address - Zip Code:49445-2731
Practice Address - Country:US
Practice Address - Phone:231-749-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-23
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health Worker