Nurse Practitioner, Family
MICHIGAN STATE UNIVERSITY
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1639253784 · enumerated 2006-10-25 · record updated 2018-04-05. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: LISA RUCKER, Enrollment & Patient Accts Manager · (517) 884-2976
Addresses and phones
- Mailing address 804 SERVICE RD # A109F, EAST LANSING, MI, 48824-7015 (517) 884-2976 Fax (517) 432-3928 Google Maps Apple Maps OpenStreetMap
- Practice location 804 SERVICE RD STE A142, EAST LANSING, MI, 48824-7015 (517) 353-3050 Fax (517) 432-3742 Google Maps Apple Maps OpenStreetMap
Specialties
- Registered Nurse 163W00000X
- Internal Medicine, Rheumatology 207RR0500X
- Physician Assistant 363A00000X
- Nurse Practitioner, Gerontology 363LG0600X
- Nurse Practitioner, Pediatrics 363LP0200X
- Nurse Practitioner, Women's Health 363LW0102X
- Nurse Practitioner, Family 363LF0000X · Primary
In this directory
Locations and evidence
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Practice location
EAST LANSING, MI, 488247015
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.