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General NPI Number Information
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NPI Number | 1225825524
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Entity Type | Individual
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Provider Name | ELIZABETH MCGORY FNP
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Gender | Female
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Dates
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Enumeration Date | 04/22/2025
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Last Update Date | 05/17/2025
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Provider Practice Location Address
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Address Line | 6889 ORCHARD LAKE RD
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-3415
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Country | US
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Telephone | 248-677-5974
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Fax |
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Provider Business Mailing Address
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Address Line | 5313 MOSER LN
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City | PERRYSBURG
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State | OH
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Zip | 43551-7194
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Country | US
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Telephone | 419-357-4807
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WM0705X
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Taxonomy Name | Medical-Surgical Registered Nurse
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License Number | 4704421555
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | APRN.CNP.0036948
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License Number State | OH
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