Healthcare Provider Details

I. General information

NPI: 1942327424
Provider Name (Legal Business Name): ELIZABETH ERIN WALVOORD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/22/2007
Last Update Date: 07/21/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

555 S 70TH ST
LINCOLN NE
68510-2462
US

IV. Provider business mailing address

18605 S 120TH ST
HICKMAN NE
68372-9760
US

V. Phone/Fax

Practice location:
  • Phone: 402-219-7420
  • Fax:
Mailing address:
  • Phone: 402-580-4025
  • Fax: 402-219-7651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number110649
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code363LN0005X
TaxonomyCritical Care Neonatal Nurse Practitioner
License Number5922
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: