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General NPI Number Information
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NPI Number | 1700043387
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Entity Type | Individual
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Provider Name | ELIZABETH ANN OUTTEN PA-C
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Gender | Female
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Dates
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Enumeration Date | 05/21/2008
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Last Update Date | 05/15/2015
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Provider Practice Location Address
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Address Line | 1113 S STATE ST
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City | DOVER
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State | DE
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Zip | 19901-4112
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Country | US
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Telephone | 302-735-8720
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Fax | 302-735-8724
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Provider Business Mailing Address
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Address Line | 1113 S STATE ST
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City | DOVER
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State | DE
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Zip | 19901-4112
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Country | US
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Telephone | 302-735-8720
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Fax | 302-735-8724
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | C50000614
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License Number State | DE
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | C5-0000614
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License Number State | DE
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