Individual provider · Type 1 NPI
Laura Rae Shirley, CNP
Family Nurse Practitioner · Grand Rapids, MI
NPI number
1639769284
Active
Practice location
4069 Lake Dr SE
Grand Rapids, MI 49546-8816
Mailing address
100 Michigan St NE, Mc 845
Grand Rapids, MI 49503-2560
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 4704425190 (MI) |
Family Nurse Practitioner: Definition to come...
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About NPI 1639769284
Laura Rae Shirley, CNP's National Provider Identifier is 1639769284, issued on Jan 18, 2021. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Grand Rapids, MI. The record was last updated on Sep 15, 2025.