Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | R080623 | MD |
NPI | 1043210032 |
---|---|
Provider Name | Elizabeth Pilkington Sipala |
First Address | Chestertown, MD 21620-3407 |
Second Address | Chestertown, MD 21620-2310 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/07/2005 |
Last Update Date | 26/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
156031000 | (05) | MD |
R91367 | (02) |