| Doctor Name: | LAURA LYNNE DERUITER |
| NPI Number: | 1750525424 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN,IBCLC |
| License Number: | 4704125868 |
| Business Practice Address: | 1809 N Young Rd Hart, MI - 494208843 |
| Business Phone Number: | 2318733259 |
| Business Fax Number: | 2318738320 |
| Mailing Address: | 1809 N Young Rd, HART |
| State: | MI |
| Postal Code: | 494208843 |
| Phone Number: | 2318733259 |
| Fax Number: | 2318738320 |
| NPI Enumeration Date: | 04/27/2009 |
| NPI Last Update Date: | 04/27/2009 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WL0100X |
| License Number: | 4704125868 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Lactation Consultant |
| Taxonomy Definition: | |