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General NPI Number Information
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NPI Number | 1003206046
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Entity Type | Individual
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Provider Name | ELIZABETH L MATHIS CNP
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Gender | Female
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Dates
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Enumeration Date | 01/29/2015
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Last Update Date | 02/25/2025
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Provider Practice Location Address
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Address Line | 1611 27TH ST STE F301
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City | PORTSMOUTH
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State | OH
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Zip | 45662-6931
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Country | US
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Telephone | 740-356-7546
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Fax | 740-356-8077
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Provider Business Mailing Address
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Address Line | 1735 27TH ST STE B06
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City | PORTSMOUTH
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State | OH
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Zip | 45662-2681
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Country | US
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Telephone | 740-356-8681
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Fax | 740-356-1256
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN.CNP.0034195
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License Number State | OH
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