Individual
ELIZABETH A ROOT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2104 JOLLY RD, SUITE 220, OKEMOS, MI 48864-6038
(517) 381-2700
(517) 381-2727
Mailing address
401 S BALLENGER HWY, FLINT, MI 48532-3638
(810) 342-1000
(810) 342-1590
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
4704155806
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500C313830
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/12/2007
Last updated
12/02/2008
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