Provider Demographics
NPI:1275119224
Name:CIERPKA, ELIZABETH MARIA (APRN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIA
Last Name:CIERPKA
Suffix:
Gender:F
Credentials:APRN
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Mailing Address - Street 1:14690 SPRING HILL DR STE 305
Mailing Address - Street 2:
Mailing Address - City:SPRING HILL
Mailing Address - State:FL
Mailing Address - Zip Code:34609-8102
Mailing Address - Country:US
Mailing Address - Phone:352-277-5348
Mailing Address - Fax:352-606-2857
Practice Address - Street 1:12083 CORTEZ BLVD
Practice Address - Street 2:
Practice Address - City:BROOKSVILLE
Practice Address - State:FL
Practice Address - Zip Code:34613-7350
Practice Address - Country:US
Practice Address - Phone:352-596-4022
Practice Address - Fax:352-596-9851
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-21
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLAPRN11009384363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL11009384OtherAPRN