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1760764732
LACIE L FEDEWA
GRAND RAPIDS, MI
NPI
1760764732
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Former Name
LACIE L LORKOWSKI
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: MI 4704254325)
Enumeration Date
2011-09-15
Last Update Date
2011-09-15
Business Address
-- LACIE L FEDEWA NP
3322 E BELTLINE CT NE
GRAND RAPIDS, MI 49525-9480
Phone number: 616-267-7015
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Mailing Address
-- LACIE L FEDEWA NP
100 MICHIGAN ST NE MC845
GRAND RAPIDS, MI 49503-2560
Phone number:
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