Provider Demographics
NPI:1861804155
Name:LEFERMAN, PAULA C (MSN, RN, APRN- BC)
Entity type:Individual
Prefix:
First Name:PAULA
Middle Name:C
Last Name:LEFERMAN
Suffix:
Gender:F
Credentials:MSN, RN, APRN- BC
Other - Prefix:
Other - First Name:PAULA
Other - Middle Name:C
Other - Last Name:LASALA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:13359 WINDHAM DR
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:MI
Mailing Address - Zip Code:48094-3175
Mailing Address - Country:US
Mailing Address - Phone:586-260-9424
Mailing Address - Fax:
Practice Address - Street 1:58024 VAN DYKE RD
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:MI
Practice Address - Zip Code:48094-4518
Practice Address - Country:US
Practice Address - Phone:586-781-5535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-21
Last Update Date:2014-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704223396363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health