Healthcare Provider Details

I. General information

NPI: 1023932043
Provider Name (Legal Business Name): ELIZABETH PIPER NITZ APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 BLATCHLEY AVE
SOUTHINGTON CT
06489-4102
US

IV. Provider business mailing address

55 BLATCHLEY AVE
SOUTHINGTON CT
06489-4102
US

V. Phone/Fax

Practice location:
  • Phone: 860-770-0503
  • Fax:
Mailing address:
  • Phone: 860-770-0503
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number18011
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: