Individual
ELIZABETH L. HALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DNP, FNP
Contact information
Practice address
311 BOYD BLVD, LA PORTE, IN 46350-3965
(219) 326-5434
Mailing address
2550 MEADOWBROOK RD, SUITE 110, BENTON HARBOR, MI 49022-9609
(269) 985-4433
(269) 985-4494
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
4704277511
MI
363LF0000X
Family Nurse Practitioner
Primary
71001231A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000353463
ANTHEM, BCBS
IN
05
—
200349050
—
IN
Enumeration date
06/14/2005
Last updated
11/11/2015
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