Provider Demographics
NPI:1306039946
Name:ARANDA, ELIZABETH (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ARANDA
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 2ND AVE S
Mailing Address - Street 2:
Mailing Address - City:NORTH MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29582-3108
Mailing Address - Country:US
Mailing Address - Phone:433-662-7148
Mailing Address - Fax:
Practice Address - Street 1:1120 2ND AVE S
Practice Address - Street 2:
Practice Address - City:NORTH MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29582-3108
Practice Address - Country:US
Practice Address - Phone:843-366-2714
Practice Address - Fax:843-366-2455
Is Sole Proprietor?:No
Enumeration Date:2007-08-27
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC26740363LW0102X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
INP01058800OtherRR MEDICARE PTAN
IN000000531290OtherANTHEM PIN
IN201005890Medicaid
IN201005890Medicaid
IN000000531290OtherANTHEM PIN
INM400044912Medicare PIN
INM400044911Medicare PIN
INM400044909Medicare PIN
IN201005890Medicaid
INM400044910Medicare PIN
INP01058800OtherRR MEDICARE PTAN
IN35-1858624OtherTIN
INM400053737Medicare PIN