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Dr. Lenae E Vanwagnen, MD
Specialist in Jackson, Michigan
NPI 1689626400

Lenae E Vanwagnen is a Specialist based in Jackson, MI. Lenae E Vanwagnen practices in Jackson, MI and has the professional credentials of MD. The NPI Number for Lenae E Vanwagnen is 1689626400 and holds a License No. 4301076691 (Michigan).

The current practice location address for Lenae E Vanwagnen is 2100 4Th St, Jackson, MI and can be reached out via phone at 517-787-4330 and via fax at 517-787-4861.

Location: 2100 4Th St, Jackson, MI, 49203-4518
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1689626400
Provider Name
Lenae E Vanwagnen
Credential
MD
Provider Entity Type
Individual
Gender
Female
Address
2100 4Th St, Jackson, MI, 49203-4518
Phone Number
517-787-4330
Fax Number
517-787-4861
Provider Enumeration Date
05/17/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
3503810402 01 MI BCBS
7766500 01 MI AETNA
139374 01 MI PREFERRED CHOICES
4538139 05 MI
200000005064 01 MI PHP
institution
Provider Business Practice Location Address Details
Address
2100 4Th St
City
Jackson
State
Michigan
Zip
49203-4518
Phone Number
517-787-4330
Fax Number
517-787-4861
person
Provider Business Mailing Address Details
Address
2100 4Th St
City
Jackson
State
Michigan
Zip
49203-4518
Phone Number
517-787-4330
Fax Number
517-787-4861
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Specialist
Speciality
-
Taxonomy
174400000X
License No.
4301076691 (Michigan)
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
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