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Individual

ELIZABETH SOCHA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
13355 E 10 MILE RD, WARREN, MI 48089-2048
(586) 756-7005
(586) 756-7006
Mailing address
13301 25 MILE RD, SHELBY TOWNSHIP, MI 48315-1316
(313) 575-3205

Taxonomy

Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
4704116812
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
10-4821399
MI
01
382962430009
TRICARE CHAMPUS
MI
05
4821399
MI
Enumeration date
01/10/2007
Last updated
11/12/2010
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