Provider Demographics
NPI:1972105112
Name:LEFLER, ELIZABETH M (NP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:LEFLER
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:M
Other - Last Name:MAVIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3092 MOORE ST
Mailing Address - Street 2:
Mailing Address - City:MARLETTE
Mailing Address - State:MI
Mailing Address - Zip Code:48453-1338
Mailing Address - Country:US
Mailing Address - Phone:989-917-0143
Mailing Address - Fax:
Practice Address - Street 1:2750 MAIN ST STE 2
Practice Address - Street 2:
Practice Address - City:MARLETTE
Practice Address - State:MI
Practice Address - Zip Code:48453-1100
Practice Address - Country:US
Practice Address - Phone:989-635-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-12
Last Update Date:2022-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266421363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care