Provider Demographics
NPI:1659180537
Name:ALBULOV, ELIZABETH N (RN, MSN, PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:N
Last Name:ALBULOV
Suffix:
Gender:F
Credentials:RN, MSN, PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13927 MARION
Mailing Address - Street 2:
Mailing Address - City:REDFORD
Mailing Address - State:MI
Mailing Address - Zip Code:48239-2841
Mailing Address - Country:US
Mailing Address - Phone:248-761-7757
Mailing Address - Fax:
Practice Address - Street 1:13927 MARION
Practice Address - Street 2:
Practice Address - City:REDFORD
Practice Address - State:MI
Practice Address - Zip Code:48239-2841
Practice Address - Country:US
Practice Address - Phone:248-761-7757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI24347050505363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health