Provider Demographics
NPI:1285641738
Name:PRICE, ELIZABETH YVETTE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:YVETTE
Last Name:PRICE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2806 TRARICH RD
Mailing Address - Street 2:
Mailing Address - City:PETERSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23805-2615
Mailing Address - Country:US
Mailing Address - Phone:804-862-8004
Mailing Address - Fax:804-862-6158
Practice Address - Street 1:111 MORTON AVE
Practice Address - Street 2:
Practice Address - City:PETERSBURG
Practice Address - State:VA
Practice Address - Zip Code:23805-2749
Practice Address - Country:US
Practice Address - Phone:804-862-8004
Practice Address - Fax:804-862-6158
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0002050868164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0002050868OtherLPN