Healthcare Provider Details

I. General information

NPI: 1851556971
Provider Name (Legal Business Name): ELIZABETH MARIE CARRINGTON FNP-RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/29/2008
Last Update Date: 07/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11611 PINE LAKE RD
PLAINWELL MI
49080-9225
US

IV. Provider business mailing address

7646 RICHLAND WOODS CT
RICHLAND MI
49083-9796
US

V. Phone/Fax

Practice location:
  • Phone: 269-664-9208
  • Fax: 269-664-9295
Mailing address:
  • Phone: 269-629-9080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WR0400X
TaxonomyRehabilitation Registered Nurse
License Number470414887
License Number StateMI
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number4704148897
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: