Healthcare Provider Details

I. General information

NPI: 1225179211
Provider Name (Legal Business Name): ELIZABETH SUSAN SCHIERHOLZ NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/10/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3020 CHILDRENS WAY
SAN DIEGO CA
92123-4223
US

IV. Provider business mailing address

8465 REGENTS RD APT 110
SAN DIEGO CA
92122-1372
US

V. Phone/Fax

Practice location:
  • Phone: 858-576-1700
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License NumberTNPC 4224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: