Provider Demographics
NPI:1497767180
Name:SHAPIRO, ELIZABETH ANNE (MS,CRNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANNE
Last Name:SHAPIRO
Suffix:
Gender:F
Credentials:MS,CRNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:BLACK
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, CRNP
Mailing Address - Street 1:8821 COLUMBIA 100 PKWY
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21045-2168
Mailing Address - Country:US
Mailing Address - Phone:410-997-1700
Mailing Address - Fax:410-740-8315
Practice Address - Street 1:8821 COLUMBIA 100 PKWY
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-2168
Practice Address - Country:US
Practice Address - Phone:410-997-1700
Practice Address - Fax:410-740-8315
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR056247363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics