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NPI Code Detail

MEDICARE: ELIZABETH GRACE MCNAUGHTON CRNP

MEDICARE: ELIZABETH GRACE MCNAUGHTON CRNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner1-159424AL

General Provider Information

NPI Number : 1649917196
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH GRACE MCNAUGHTON CRNP
Provider Business Mailing Address
First Line : 46 L V STABLER DR
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-3865
Country : US
Telephone Number : 334-382-9760
Fax Number : 334-383-9331
Provider Business Practice Location Address
First Line : 46 L V STABLER DR
Second Line :
City : GREENVILLE
State : AL
Zip : 36037-3865
Country : US
Telephone Number : 334-382-9760
Fax Number : 334-383-9331
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2022
Last Update Date : 05/17/2022

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