Healthcare Provider Details

I. General information

NPI: 1346725199
Provider Name (Legal Business Name): ELIZABETH BYRD NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2018
Last Update Date: 01/30/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

45 CASTRO ST
SAN FRANCISCO CA
94114-1010
US

IV. Provider business mailing address

45 CASTRO ST STE 160A
SAN FRANCISCO CA
94114-1010
US

V. Phone/Fax

Practice location:
  • Phone: 415-600-6616
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LX0106X
TaxonomyOccupational Health Nurse Practitioner
License Number95009871
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: