Healthcare Provider Details

I. General information

NPI: 1063718443
Provider Name (Legal Business Name): ELIZABETH FLUHARTY NNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/02/2011
Last Update Date: 02/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

725 WELCH RD
PALO ALTO CA
94304-1601
US

IV. Provider business mailing address

219 SANTA MARGARITA AVE
MENLO PARK CA
94025-2726
US

V. Phone/Fax

Practice location:
  • Phone: 650-497-8800
  • Fax:
Mailing address:
  • Phone: 650-853-1751
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number584709
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: