Healthcare Provider Details

I. General information

NPI: 1477003002
Provider Name (Legal Business Name): ELIZABETH JAMISON ESCOFFERY CFCP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/06/2016
Last Update Date: 11/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

85 E CEDAR ST
ZIONSVILLE IN
46077-1502
US

IV. Provider business mailing address

85 E CEDAR ST
ZIONSVILLE IN
46077-1502
US

V. Phone/Fax

Practice location:
  • Phone: 317-721-7332
  • Fax:
Mailing address:
  • Phone: 317-721-7332
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174H00000X
TaxonomyHealth Educator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: