Provider Demographics
NPI:1205012895
Name:ALDEN, ELIZABETH R (RN,)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:R
Last Name:ALDEN
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 1:10 MANZANO RD
Mailing Address - Street 2:
Mailing Address - City:CORRALES
Mailing Address - State:NM
Mailing Address - Zip Code:87048-8385
Mailing Address - Country:US
Mailing Address - Phone:505-828-2134
Mailing Address - Fax:505-856-5530
Practice Address - Street 1:10 MANZANO RD
Practice Address - Street 2:
Practice Address - City:CORRALES
Practice Address - State:NM
Practice Address - Zip Code:87048-8385
Practice Address - Country:US
Practice Address - Phone:505-828-2134
Practice Address - Fax:505-856-5530
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-14
Last Update Date:2008-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR21244374T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel