Provider Demographics
NPI:1164675757
Name:ENDERLE, ELIZABETH CATHARINE (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CATHARINE
Last Name:ENDERLE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 KING AVE SW
Mailing Address - Street 2:
Mailing Address - City:PATASKALA
Mailing Address - State:OH
Mailing Address - Zip Code:43062-8427
Mailing Address - Country:US
Mailing Address - Phone:614-937-9917
Mailing Address - Fax:
Practice Address - Street 1:61 KING AVE SW
Practice Address - Street 2:
Practice Address - City:PATASKALA
Practice Address - State:OH
Practice Address - Zip Code:43062-8427
Practice Address - Country:US
Practice Address - Phone:614-937-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-28
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH356273163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse