Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | 5003505 | NC |
N | 363LC1500X | Nurse Practitioner - Community Health | 5003505 | NC |
NPI | 1134349301 |
---|---|
Provider Name | Ms. Elizabeth Walker Boozer |
First Address | Roxboro, NC 27573-4755 |
Second Address | Roxboro, NC 27573-4755 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/04/2007 |
Last Update Date | 22/02/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
7005269 | (05) | NC |