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NPI Code Detail

MEDICARE: ELIZEBETH EDMISTER CRNP

MEDICARE: ELIZEBETH EDMISTER 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 PractitionerSP027924PA

General Provider Information

NPI Number : 1972284487
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZEBETH EDMISTER CRNP
Provider Business Mailing Address
First Line : PO BOX 858
Second Line : MC CA410
City : HERSHEY
State : PA
Zip : 17033-0858
Country : US
Telephone Number : 800-243-1455
Fax Number :
Provider Business Practice Location Address
First Line : 335 LAMBS GAP RD
Second Line :
City : MECHANICSBURG
State : PA
Zip : 17050-2784
Country : US
Telephone Number : 717-591-1425
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2023
Last Update Date : 07/27/2023

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