Healthcare Provider Details

I. General information

NPI: 1295200475
Provider Name (Legal Business Name): ELIZABETH BERNADETTEMARINO CONDIT FNP-C, AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2018
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18930 KUYKENDAHL RD STE C
SPRING TX
77379-5588
US

IV. Provider business mailing address

18930 KUYKENDAHL RD STE C
SPRING TX
77379-5588
US

V. Phone/Fax

Practice location:
  • Phone: 281-753-1952
  • Fax:
Mailing address:
  • Phone: 281-626-0784
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAP139075
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP139075
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP139075
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: