Healthcare Provider Details

I. General information

NPI: 1174661243
Provider Name (Legal Business Name): ELIZABETH LAYNE LINDQUIST RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

BLDG 245 NEW ARGONER KASSERNE
HANAU HESSEN
63457
DE

IV. Provider business mailing address

CMR 401 BOX # 776
APO AE
09076
DE

V. Phone/Fax

Practice location:
  • Phone: 0114961815006627
  • Fax:
Mailing address:
  • Phone: 011496058917906
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number0000155385
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: