Provider Demographics
NPI:1437531001
Name:MAYS, ELIZABETH LOUISE (LICENSED ESTHETICIAN)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:LOUISE
Last Name:MAYS
Suffix:
Gender:F
Credentials:LICENSED ESTHETICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 STATE FARM RD
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-5307
Mailing Address - Country:US
Mailing Address - Phone:828-386-1172
Mailing Address - Fax:
Practice Address - Street 1:838 STATE FARM RD
Practice Address - Street 2:SUITE 1
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-5307
Practice Address - Country:US
Practice Address - Phone:828-386-1172
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-19
Last Update Date:2015-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCE15616174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist