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NPI Code Detail

MEDICARE: ELIZABETH THORNE RN

MEDICARE:   ELIZABETH  THORNE  RN
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
1163WS0200XSchool Registered Nurse744516CA

General Provider Information

NPI Number : 1780218859
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH THORNE RN
Provider Business Mailing Address
First Line : 250 E BEACH ST
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-4831
Country : US
Telephone Number : 831-728-6390
Fax Number :
Provider Business Practice Location Address
First Line : 250 E BEACH ST
Second Line :
City : WATSONVILLE
State : CA
Zip : 95076-4831
Country : US
Telephone Number : 831-728-6390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/27/2020
Last Update Date : 02/27/2020

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