1225283583 NPI number — MISS ELIZABETH ANNE STUART ANP-BC

Table of content: MISS ELIZABETH ANNE STUART ANP-BC (NPI 1225283583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225283583 NPI number — MISS ELIZABETH ANNE STUART ANP-BC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
STUART
Provider First Name:
ELIZABETH
Provider Middle Name:
ANNE
Provider Name Prefix Text:
MISS
Provider Name Suffix Text:
Provider Credential Text:
ANP-BC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1225283583
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5730 EXECUTIVE DR STE 230
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CATONSVILLE
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
21228-1762
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
410-402-2379
Provider Business Mailing Address Fax Number:
248-668-8788

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
FOX RUN SENIOR LIVING
Provider Second Line Business Practice Location Address:
41000 13 MILE ROAD
Provider Business Practice Location Address City Name:
NOVI
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
48377
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
248-668-8785
Provider Business Practice Location Address Fax Number:
248-668-8788
Provider Enumeration Date:
11/29/2008

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: 363LP2300X , with the licence number:  4704169685 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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