Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LA2100X | Nurse Practitioner - Acute Care | APRN.CNP.0027717 | OH |
Y | 363LA2200X | Nurse Practitioner - Adult Health | APRN.CNP.0027717 | OH |
N | 363LG0600X | Nurse Practitioner - Gerontology | APRN.CNP.0027717 | OH |
NPI | 1083200992 |
---|---|
Provider Name | Elizabeth Grace Carrier |
First Address | Boardman, OH 44512-6725 |
Second Address | Boardman, OH 44512-6725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/12/2020 |
Last Update Date | 15/12/2020 |