Healthcare Provider Details

I. General information

NPI: 1083822803
Provider Name (Legal Business Name): ELAINE ANN ENGELSMAN NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELAINE A LEIGH D-NP

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4277 OKEMOS RD STE 100
OKEMOS MI
48864-3282
US

IV. Provider business mailing address

4277 OKEMOS RD STE 100
OKEMOS MI
48864-3282
US

V. Phone/Fax

Practice location:
  • Phone: 517-816-8723
  • Fax: 517-247-3558
Mailing address:
  • Phone: 517-816-8723
  • Fax: 517-247-3558

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704164318
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: