Healthcare Provider Details
I. General information
NPI: 1841522109
Provider Name (Legal Business Name): ELIZABETH ELVIRIA ANDERSON RN, BSN, CM, DN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 02/10/2010
Last Update Date: 02/15/2010
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1852 PLEASANT VIEW RD
ADAMSTOWN MD
21710-9011
US
IV. Provider business mailing address
1852 PLEASANT VIEW RD
ADAMSTOWN MD
21710-9011
US
V. Phone/Fax
- Phone: 301-874-2099
- Fax: 301-874-2099
- Phone: 301-874-2099
- Fax: 301-874-2099
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 4 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WA2000X |
| Taxonomy | Administrator Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 5 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 6 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC0400X |
| Taxonomy | Case Management Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 7 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1400X |
| Taxonomy | College Health Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 8 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 9 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 163WC1500X |
| Taxonomy | Community Health Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 10 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1600X |
| Taxonomy | Continuing Education/Staff Development Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 11 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WC1600X |
| Taxonomy | Continuing Education/Staff Development Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 12 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
| # 13 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WG0000X |
| Taxonomy | General Practice Registered Nurse |
| License Number | RN1004478 |
| License Number State | DC |
| # 14 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163WM0705X |
| Taxonomy | Medical-Surgical Registered Nurse |
| License Number | R156712 |
| License Number State | MD |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone:
