Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 4704149005 | MI |
N | 363LA2100X | Nurse Practitioner - Acute Care | 4704149005 | MI |
N | 363LC0200X | Nurse Practitioner - Critical Care Medicine | 4704149005 | MI |
NPI | 1295821338 |
---|---|
Provider Name | Loraine Marie Ducharme |
First Address | Ann Arbor, MI 48108 |
Second Address | Ann Arbor, MI 48109-5864 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 14/01/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q61550 | (02) | MI |