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General NPI Number Information
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NPI Number | 1083676993
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Entity Type | Individual
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Provider Name | ELIZABETH BOOTH MYHRE NURSE PRACTITIONER
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Gender | Female
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Dates
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Enumeration Date | 04/05/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | NATIONAL NAVAL MEDICAL CENTER 8901 WISCONSIN AVE
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City | BETHESDA
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State | MD
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Zip | 20889-0001
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Country | US
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Telephone | 301-295-5600
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Fax |
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Provider Business Mailing Address
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Address Line | 2904 RITTENHOUSE ST NW
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City | WASHINGTON
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State | DC
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Zip | 20015-1524
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Country | US
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Telephone | 202-364-9669
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Fax |
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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 | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 0001106356
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License Number State | VA
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