Park, Elizabeth A

Park, Elizabeth A is an individual health care provider with primary practice located at 1206 Highway 411 , Vonore TN 37885-2455. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Park, Elizabeth A can be contacted via phone (423) 442-2622.

Contact Information

Primary practice address
1206 Highway 411 Vonore TN 37885-2455
Fax: (423) 442-5760
Website:

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 6439 Tennessee

Profile Details

NPI number 1447255096
LBN Legal business name Park, Elizabeth A
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 19th, 2005
Last updated Jul 9th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447255096 NPPES
Tennessee MEDICAID 3901053
Tennessee MEDICAID 3901052
Tennessee MEDICAID 1506981

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