Provider Demographics
NPI:1164521787
Name:RAPER, ELIZABETH ANNE (CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:RAPER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 AVALON AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:MUSCLE SHOALS
Mailing Address - State:AL
Mailing Address - Zip Code:35661-3164
Mailing Address - Country:US
Mailing Address - Phone:256-386-0809
Mailing Address - Fax:256-383-8000
Practice Address - Street 1:2400 AVALON AVE
Practice Address - Street 2:SUITE B
Practice Address - City:MUSCLE SHOALS
Practice Address - State:AL
Practice Address - Zip Code:35661-3164
Practice Address - Country:US
Practice Address - Phone:256-386-0809
Practice Address - Fax:256-383-8000
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2013-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL036688-22363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051528393Medicaid
ALQ6977Medicare UPIN
051528393Medicare PIN