Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LN0000X | Nurse Practitioner - Neonatal | 4704309394 | MI |
NPI | 1104596899 |
---|---|
Provider Name | Teanna Suel Piper |
First Address | East Lansing, MI 48824-7015 |
Second Address | Lansing, MI 48912-1896 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2021 |
Last Update Date | 14/10/2021 |