Provider Demographics
NPI:1487651642
Name:HOUGLAN, ELIZABETH RITA (CNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:RITA
Last Name:HOUGLAN
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1391 W 5TH AVE
Mailing Address - Street 2:SUITE 260
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43212-2902
Mailing Address - Country:US
Mailing Address - Phone:844-326-3119
Mailing Address - Fax:855-406-7157
Practice Address - Street 1:1391 W. 5TH AVE
Practice Address - Street 2:SUITE 260
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43212
Practice Address - Country:US
Practice Address - Phone:844-326-3119
Practice Address - Fax:855-406-7157
Is Sole Proprietor?:No
Enumeration Date:2005-07-02
Last Update Date:2016-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHNP03036363LA2200X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2023652Medicaid
OHNP15795Medicare PIN
OH2023652Medicaid