Provider Demographics
NPI:1093765679
Name:GODLOVE, ELIZABETH (RN,A/GNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:GODLOVE
Suffix:
Gender:F
Credentials:RN,A/GNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000 WEST LOOP S
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77027-3513
Mailing Address - Country:US
Mailing Address - Phone:281-740-7606
Mailing Address - Fax:281-879-1495
Practice Address - Street 1:2000 WEST LOOP S
Practice Address - Street 2:SUITE 900
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77027-3513
Practice Address - Country:US
Practice Address - Phone:281-740-7606
Practice Address - Fax:281-879-1495
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2015-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX437521363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXGNP012521Medicaid
TX85N449Medicare ID - Type UnspecifiedMEDICARE
TXGNP012521Medicaid