Provider Demographics
NPI:1386828887
Name:HRANCHOOK-EHARDT, HELEN VICTORIA (PA - C)
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:VICTORIA
Last Name:HRANCHOOK-EHARDT
Suffix:
Gender:F
Credentials:PA - C
Other - Prefix:MRS
Other - First Name:HELEN
Other - Middle Name:VICTORIA
Other - Last Name:EHARDT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA - C
Mailing Address - Street 1:33720 HARPER AVE
Mailing Address - Street 2:
Mailing Address - City:CLINTON TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48035-4255
Mailing Address - Country:US
Mailing Address - Phone:586-294-5210
Mailing Address - Fax:586-294-0215
Practice Address - Street 1:33720 HARPER AVE
Practice Address - Street 2:
Practice Address - City:CLINTON TOWNSHIP
Practice Address - State:MI
Practice Address - Zip Code:48035-4255
Practice Address - Country:US
Practice Address - Phone:586-294-5210
Practice Address - Fax:586-294-0215
Is Sole Proprietor?:No
Enumeration Date:2007-12-20
Last Update Date:2012-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601001507363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant