Provider Demographics
NPI:1841955176
Name:HENSCHEL, ELIZABETH ANNE (AGPCNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:HENSCHEL
Suffix:
Gender:F
Credentials:AGPCNP
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:HENSCHEL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ELIZABETH HUDSON
Mailing Address - Street 1:1555 GRIGGS ST SE
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49507-2826
Mailing Address - Country:US
Mailing Address - Phone:269-352-1807
Mailing Address - Fax:
Practice Address - Street 1:5950 METRO WAY SW
Practice Address - Street 2:
Practice Address - City:WYOMING
Practice Address - State:MI
Practice Address - Zip Code:49519-9514
Practice Address - Country:US
Practice Address - Phone:616-252-8100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-02
Last Update Date:2021-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704300332363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health