Healthcare Provider Details

I. General information

NPI: 1376969956
Provider Name (Legal Business Name): ELIZABETH LUNZ RNFA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2014
Last Update Date: 03/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1700 13TH ST
EVERETT WA
98201-1689
US

IV. Provider business mailing address

1700 13TH ST
EVERETT WA
98201-1689
US

V. Phone/Fax

Practice location:
  • Phone: 425-404-5415
  • Fax:
Mailing address:
  • Phone: 425-404-5415
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WR0006X
TaxonomyRegistered Nurse First Assistant
License NumberRN00094537
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: