Vanwagnen, Lenae E

Vanwagnen, Lenae E is an individual health care provider with primary practice located at 2100 4Th St , Jackson MI 49203-4518. She recently has only one registered license in Other Service Providers / Specialist, which is considered as her primary health care specialty. Vanwagnen, Lenae E can be contacted via phone (517) 787-4330.

Contact Information

Primary practice address
2100 4Th St Jackson MI 49203-4518
Phone: (517) 787-4330
Fax: (517) 787-4861
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 4301076691 Michigan

Profile Details

NPI number 1689626400
LBN Legal business name Vanwagnen, Lenae E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 17th, 2006
Last updated Dec 18th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1689626400 NPPES
Michigan Other 3503810402 BCBS
Michigan Other 7766500 BCBS
Michigan Other 139374 BCBS
Michigan MEDICAID 4538139 BCBS
Michigan Other 200000005064 BCBS

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