Provider Demographics
NPI:1205535671
Name:RANSOM, ELIZABETH RENEE
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RENEE
Last Name:RANSOM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12414 COSTER RD SW
Mailing Address - Street 2:
Mailing Address - City:FIFE LAKE
Mailing Address - State:MI
Mailing Address - Zip Code:49633-8407
Mailing Address - Country:US
Mailing Address - Phone:231-388-4447
Mailing Address - Fax:
Practice Address - Street 1:12414 COSTER RD SW
Practice Address - Street 2:
Practice Address - City:FIFE LAKE
Practice Address - State:MI
Practice Address - Zip Code:49633-8407
Practice Address - Country:US
Practice Address - Phone:231-388-4447
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI470428807163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development