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General NPI Number Information
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NPI Number | 1588045934
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Entity Type | Individual
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Provider Name | ELIZABETH BODDIE
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Gender | Female
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Dates
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Enumeration Date | 06/11/2015
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Last Update Date | 12/05/2015
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Provider Practice Location Address
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Address Line | 3 S TUNNEL RD
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City | ASHEVILLE
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State | NC
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Zip | 28805-2238
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Country | US
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Telephone | 828-298-0125
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Fax |
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Provider Business Mailing Address
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Address Line | 98 MOORES VALLEY RD
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City | LEICESTER
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State | NC
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Zip | 28748-5119
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Country | US
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Telephone |
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 239076
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License Number State | NC
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