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General NPI Number Information
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NPI Number | 1760922371
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Entity Type | Individual
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Provider Name | ELSIE LAUREL MAXIN RNP
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Gender | Female
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Dates
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Enumeration Date | 03/01/2017
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Last Update Date | 09/26/2025
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Provider Practice Location Address
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Address Line | 4539 N 22ND ST STE N
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 239-766-0677
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Fax |
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Provider Business Mailing Address
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Address Line | 4539 N 22ND ST STE N
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City | PHOENIX
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State | AZ
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Zip | 85016-4639
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Country | US
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Telephone | 239-766-0677
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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 | APRN9488439
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | SP017235
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License Number State | PA
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Taxonomy #3
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN9488439
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN691406
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License Number State | PA
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Taxonomy #5
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 329691
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License Number State | AZ
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