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Lauren Mankivsky

Physician Assistant

Physician Assistants & Advanced Practice Nursing Providers

100 Michigan St NE, Suite A721, Grand Rapids, MI 49503

PECOS Enrollment

Based on the most recent information from CMS, provider Lauren Mankivsky is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records today at 10:37 AM.

Profile Details

Provider ID
1215348537
Provider Type
Individual
Full Name
Mankivsky, Lauren
Credential
PHYSICIAN ASSISTANT

Gender
Female
Sole Proprietor
No
Enumeration Date
5/9/2014
Last Updated
8/28/2018

Contact Information

Practice Location

100 Michigan St NE, Suite A721, Grand Rapids, MI 49503

(616) 267-7301

(616) 391-3044

Mailing Location

5900 Byron Center Ave SW, Medical Administration, Wyoming, MI 49519-9606

(616) 252-3243

(616) 252-0260

Provider Taxonomies

Code	Description	License
Code 363A00000X Primary	Description Physician Assistant Physician Assistants & Advanced Practice Nursing Providers	License 5601007081 Michigan

Lauren Mankivsky

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Witte, Kristin

Kuiper, Benjamin Daniel

Bremer, Sarah Ruth

Meeuwsen, Kyle Donovan

Imeri, Mergime

Benso, Brent

Towns, Jenna Anne

Mcmanes, April D

Lindhout, Kathleen A

Wing, Amy Lynn