Provider Demographics
NPI:1073760476
Name:WAITE, ELIZABETH CAROL (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:CAROL
Last Name:WAITE
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE SPRINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16403-1060
Mailing Address - Country:US
Mailing Address - Phone:814-398-4313
Mailing Address - Fax:814-398-4340
Practice Address - Street 1:118 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE SPRINGS
Practice Address - State:PA
Practice Address - Zip Code:16403-1060
Practice Address - Country:US
Practice Address - Phone:814-398-4313
Practice Address - Fax:814-398-4340
Is Sole Proprietor?:No
Enumeration Date:2008-08-27
Last Update Date:2008-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOA000531-L363A00000X
PAMA 003410-L363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant