Provider Demographics
NPI:1043898836
Name:SMITH, LAUREN MARIE (BS)
Entity type:Individual
Prefix:
First Name:LAUREN
Middle Name:MARIE
Last Name:SMITH
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:LAUREN
Other - Middle Name:MARIE
Other - Last Name:VANVORST
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25872 AIRLINE RD
Mailing Address - Street 2:
Mailing Address - City:STURGIS
Mailing Address - State:MI
Mailing Address - Zip Code:49091-9771
Mailing Address - Country:US
Mailing Address - Phone:517-617-7220
Mailing Address - Fax:
Practice Address - Street 1:25872 AIRLINE RD
Practice Address - Street 2:
Practice Address - City:STURGIS
Practice Address - State:MI
Practice Address - Zip Code:49091-9771
Practice Address - Country:US
Practice Address - Phone:517-617-7220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-01
Last Update Date:2021-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator