1427713460 NPI number — MISS ELISABETH ANNE WALTKE MSW

Table of content: MISS ELISABETH ANNE WALTKE MSW (NPI 1427713460)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1427713460 NPI number — MISS ELISABETH ANNE WALTKE MSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALTKE
Provider First Name:
ELISABETH
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
MSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WASHBURN
Provider Other First Name:
ELISABETH
Provider Other Middle Name:
ANNE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1427713460
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/09/2026
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1 WASHINGTON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TAUNTON
Provider Business Mailing Address State Name:
MA
Provider Business Mailing Address Postal Code:
02780-5293
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
508-285-9400
Provider Business Mailing Address Fax Number:
508-715-3200

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1 WASHINGTON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TAUNTON
Provider Business Practice Location Address State Name:
MA
Provider Business Practice Location Address Postal Code:
02780-5293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
508-285-9400
Provider Business Practice Location Address Fax Number:
508-715-3200
Provider Enumeration Date:
11/04/2021

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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