MEDICARE: ELIZABETH P. KUSS N.P.

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	363L00000X	Nurse Practitioner	1-099808	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1-099808	OTHER	AL	ABN NURSING LICENSE

General Provider Information

NPI Number	:	1386949766
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH P. KUSS N.P.

Provider Business Mailing Address
First Line	:	340 MAGNOLIA CIR
Second Line	:
City	:	TYNDALL AFB
State	:	FL
Zip	:	32403-5612
Country	:	US
Telephone Number	:	850-283-7984
Fax Number	:

Provider Business Practice Location Address
First Line	:	340 MAGNOLIA CIR
Second Line	:
City	:	TYNDALL AFB
State	:	FL
Zip	:	32403-5612
Country	:	US
Telephone Number	:	850-283-7984
Fax Number	:

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

Provider Enumeration Date	:	01/17/2011
Last Update Date	:	01/29/2026

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