Healthcare Provider Details

I. General information

NPI: 1326327438
Provider Name (Legal Business Name): ELIZABETH NELL CAIN ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2011
Last Update Date: 11/13/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

307 FRANKLIN STREET
KEOSAUQUA IA
52565
US

IV. Provider business mailing address

307 FRANKLIN STREET
KEOSAUQUA IA
52565
US

V. Phone/Fax

Practice location:
  • Phone: 319-293-3171
  • Fax: 319-293-3174
Mailing address:
  • Phone: 319-293-3171
  • Fax: 319-293-3174

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA089117
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: