Healthcare Provider Details

I. General information

NPI: 1164023701
Provider Name (Legal Business Name): ELIZABETH LOUISE ECHOLS NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2020
Last Update Date: 11/02/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 LOUGHBORO RD NW
WASHINGTON DC
20016-2633
US

IV. Provider business mailing address

6702 PRINCE GEORGES AVE
TAKOMA PARK MD
20912-4808
US

V. Phone/Fax

Practice location:
  • Phone: 202-537-4000
  • Fax:
Mailing address:
  • Phone: 301-917-5912
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberR199986
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License NumberRN1038304
License Number StateDC
# 3
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR199986
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: