Provider Demographics
NPI:1003866195
Name:CUEVAS, ELIZABETH (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CUEVAS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7216 HIGHWAY 110 WEST
Mailing Address - Street 2:
Mailing Address - City:MERRYVILLE
Mailing Address - State:LA
Mailing Address - Zip Code:70653-3231
Mailing Address - Country:US
Mailing Address - Phone:337-825-4804
Mailing Address - Fax:
Practice Address - Street 1:2607 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:TX
Practice Address - Zip Code:77630-6133
Practice Address - Country:US
Practice Address - Phone:409-886-4407
Practice Address - Fax:409-886-5303
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01350363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P50528Medicare UPIN
AR5W813Medicare ID - Type Unspecified