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General NPI Number Information
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NPI Number | 1457355042
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Entity Type | Individual
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Provider Name | ELIZABETH HENGSTEBECK DO
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Gender | Female
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Dates
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Enumeration Date | 06/10/2005
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Last Update Date | 03/08/2017
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Provider Practice Location Address
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Address Line | 804 SERVICE RD A142
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City | EAST LANSING
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State | MI
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Zip | 48824-7015
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Country | US
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Telephone | 517-353-3050
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Fax | 517-432-3742
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Provider Business Mailing Address
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Address Line | 804 SERVICE RD A201
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City | EAST LANSING
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State | MI
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Zip | 48824-7015
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Country | US
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Telephone | 517-884-2976
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Fax | 517-432-3928
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OS8643
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 5101012728
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License Number State | MI
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