Provider Demographics
NPI:1356821516
Name:NOFTSGER, ELIZABETH A (HIS)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:NOFTSGER
Suffix:
Gender:F
Credentials:HIS
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:REESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:322 N MICHIGAN ST STE C
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:IN
Mailing Address - Zip Code:46563-1760
Mailing Address - Country:US
Mailing Address - Phone:574-936-8878
Mailing Address - Fax:574-936-8878
Practice Address - Street 1:322 N MICHIGAN ST STE C
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:IN
Practice Address - Zip Code:46563-1760
Practice Address - Country:US
Practice Address - Phone:574-936-8878
Practice Address - Fax:574-936-8878
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2018-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN17001460A237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist