Healthcare Provider Details
I. General information
NPI: 1972787711
Provider Name (Legal Business Name): ELIZABETH CAPE NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/27/2007
Last Update Date: 06/23/2025
Certification Date: 06/23/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
151 BRIAR RIDGE DR
SAN JOSE CA
95123-2662
US
IV. Provider business mailing address
PO BOX 802843
KANSAS CITY MO
64180-2843
US
V. Phone/Fax
- Phone: 408-224-0667
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 202004196 |
| License Number State | MO |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 364SE0003X |
| Taxonomy | Emergency Clinical Nurse Specialist |
| License Number | 611537 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: