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Individual

ELIZABETH A BRANNICK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA

Contact information

Practice address
1881 W GRAND RIVER AVE, OKEMOS, MI 48864-1840
(517) 339-2100
Mailing address
1881 W GRAND RIVER AVE, OKEMOS, MI 48864-1840
(517) 339-2100

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9111012
FL
363A00000X
Physician Assistant
Primary
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100013700
FL
01
JM891Z
MEDICARE
FL
Enumeration date
10/11/2016
Last updated
10/27/2022
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