Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0002X | Hospice and Palliative Medicine | 4301107860 | MI |
NPI | 1225419518 |
---|---|
Provider Name | Jayme Laurencelle |
First Address | Ann Arbor, MI 48109-5000 |
Second Address | Ann Arbor, MI 48109-5000 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2015 |
Last Update Date | 27/05/2020 |