Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0200X | Nurse Practitioner - Pediatrics | C115134 | IA |
NPI | 1043545080 |
---|---|
Provider Name | Mrs. Elizabeth Anne Faine |
First Address | Iowa City, IA 52242-1007 |
Second Address | Iowa City, IA 52242-1007 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2009 |
Last Update Date | 01/08/2014 |