Provider Demographics
NPI:1861072175
Name:NADOROZNY, ELIZABETH JEAN (CPHT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JEAN
Last Name:NADOROZNY
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1308 CLUB RD
Mailing Address - Street 2:
Mailing Address - City:ST. HELEN
Mailing Address - State:MI
Mailing Address - Zip Code:48656
Mailing Address - Country:US
Mailing Address - Phone:810-432-1420
Mailing Address - Fax:989-389-7590
Practice Address - Street 1:2010 N SAINT HELEN RD
Practice Address - Street 2:
Practice Address - City:SAINT HELEN
Practice Address - State:MI
Practice Address - Zip Code:48656-8555
Practice Address - Country:US
Practice Address - Phone:989-389-4965
Practice Address - Fax:989-389-7590
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-11
Last Update Date:2021-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5303004254156F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156F00000XEye and Vision Services ProvidersTechnician/Technologist