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General NPI Number Information
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NPI Number | 1912306341
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Entity Type | Individual
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Provider Name | ELISABETH ANNE BARLOW CNP
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Gender | Female
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Dates
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Enumeration Date | 08/21/2014
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Last Update Date | 02/25/2022
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Provider Practice Location Address
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Address Line | 3000 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-6132
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Country | US
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Telephone | 701-364-8000
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Fax | 701-364-8078
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Provider Business Mailing Address
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Address Line | 3000 32ND AVE S
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City | FARGO
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State | ND
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Zip | 58103-6132
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Country | US
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Telephone | 701-364-8000
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Fax | 701-364-8078
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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 | 111675
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 8737
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R40921
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License Number State | ND
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