Basic Information
| Provider Information | |||||||||
| NPI: | 1053689695 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HELMREICH | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | MAY | ||||||||
| NamePrefix: | MRS. | ||||||||
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| Credential: | ANP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1201 STONE ST | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | PORT HURON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480603563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109669556 | ||||||||
| FaxNumber: | 8109664898 | ||||||||
| Practice Location | |||||||||
| Address1: | 1201 STONE ST | ||||||||
| Address2: | SUITE 5 | ||||||||
| City: | PORT HURON | ||||||||
| State: | MI | ||||||||
| PostalCode: | 480603563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8109669556 | ||||||||
| FaxNumber: | 8109664898 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2011 | ||||||||
| LastUpdateDate: | 12/11/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LA2200X | 4704253705 | MI | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Adult Health |
No ID Information.