Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207K00000X | Allergist & Immunologist | 01055513 | IN |
Y | 207KA0200X | Allergist | 99-00243 | NC |
NPI | 1477529378 |
---|---|
Provider Name | Elizabeth Isbister |
First Address | Elizabeth City, NC 27909-3365 |
Second Address | Harbinger, NC 27941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 02/07/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000600333 | ANTHEM (01) | |
200358190 | (05) | IN |
G90197 | (02) | IN |