Healthcare Provider Details

I. General information

NPI: 1710239603
Provider Name (Legal Business Name): ELIZABETH FAYE ZUEHLKE RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELIZABETH FAYE GIERING

II. Dates (important events)

Enumeration Date: 10/03/2012
Last Update Date: 10/03/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5513 SIEBERT ST
MIDLAND MI
48640-0089
US

IV. Provider business mailing address

5513 SIEBERT ST
MIDLAND MI
48640-0089
US

V. Phone/Fax

Practice location:
  • Phone: 989-708-7513
  • Fax:
Mailing address:
  • Phone: 989-708-7513
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number4704144693
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: