Provider Demographics
NPI:1437920840
Name:LASCH, ELIZABETH HILLARY (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:HILLARY
Last Name:LASCH
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 1:308 COOK ST
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-1006
Mailing Address - Country:US
Mailing Address - Phone:901-488-1415
Mailing Address - Fax:
Practice Address - Street 1:7800 US HIGHWAY 98 W
Practice Address - Street 2:
Practice Address - City:MIRAMAR BEACH
Practice Address - State:FL
Practice Address - Zip Code:32550-7228
Practice Address - Country:US
Practice Address - Phone:850-278-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9523095163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency