Travis Dennis, LPN
Licensed Practical Nurse in Eastpointe, MI. Individual provider (NPI-1).
NPI number1700467974
StatusActive
Last updated in NPPESApr 19, 2021
Details
- NPI
- 1700467974
- Entity type
- Individual (NPI-1)
- Name
- Travis Dennis
- Credential
- LPN
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 19, 2021
- Certification date
- Apr 19, 2021
- Last updated
- Apr 19, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 164W00000X | Licensed Practical Nurse | 4703119474 | MI | Yes |
| 2472R0900X | Technician, Other, Renal Dialysis | – | – | |
| 164X00000X | Licensed Vocational Nurse | 4703119474 | MI | |
| 126800000X | Dental Assistant | – | – |
Practice location
24931 Kelly RdEastpointe, MI 48021-1384
Phone 586-771-0675
Mailing address
4829 Nottingham RdDetroit, MI 48224-3425
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 34 Licensed Practical Nurse providers in Eastpointe · All 773 providers in Eastpointe
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