Healthcare Provider Details

I. General information

NPI: 1164233110
Provider Name (Legal Business Name): ELVIRE A. LIZAIRE RN, BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/17/2025
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 HILLSIDE AVE
HENDERSON NC
27536-5056
US

IV. Provider business mailing address

711 HILLSIDE AVE
HENDERSON NC
27536-5056
US

V. Phone/Fax

Practice location:
  • Phone: 850-357-6123
  • Fax:
Mailing address:
  • Phone: 850-357-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN273173
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: