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General NPI Number Information
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NPI Number | 1508252495
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Entity Type | Individual
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Provider Name | ELIZABETH L. HARBISON FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 04/08/2015
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Last Update Date | 08/10/2024
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Provider Practice Location Address
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Address Line | 900 N WASHINGTON ST
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City | DU QUOIN
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State | IL
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Zip | 62832-1233
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Country | US
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Telephone | 618-542-1050
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Fax |
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Provider Business Mailing Address
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Address Line | 1221 PARK STREET RD
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City | MULKEYTOWN
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State | IL
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Zip | 62865-2307
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Country | US
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Telephone | 618-318-2472
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 277.003187
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License Number State | IL
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