MEDICARE: MRS. ELVIRE A. LIZAIRE RN, BSN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163WH0200X	Home Health Registered Nurse	RN273173	NC

General Provider Information

NPI Number	:	1164233110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ELVIRE A. LIZAIRE RN, BSN

Provider Business Mailing Address
First Line	:	711 HILLSIDE AVE
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-5056
Country	:	US
Telephone Number	:	850-357-6123
Fax Number	:

Provider Business Practice Location Address
First Line	:	711 HILLSIDE AVE
Second Line	:
City	:	HENDERSON
State	:	NC
Zip	:	27536-5056
Country	:	US
Telephone Number	:	850-357-6123
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/17/2025
Last Update Date	:	05/15/2026

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