Provider Demographics
NPI:1417546235
Name:HALTERMAN, ELIZABETH (RN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:HALTERMAN
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 1:550 GLENOAK ST N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703-2222
Mailing Address - Country:US
Mailing Address - Phone:813-802-9427
Mailing Address - Fax:
Practice Address - Street 1:550 GLENOAK ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-2222
Practice Address - Country:US
Practice Address - Phone:813-802-9427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-15
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9224965163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine