Provider Demographics
NPI:1508349341
Name:DVORAK, ELIZABETH MICHAEL (FNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MICHAEL
Last Name:DVORAK
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:MICHAEL
Other - Last Name:KRANTZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1122 1/2 8TH ST W
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-5828
Mailing Address - Country:US
Mailing Address - Phone:406-647-5426
Mailing Address - Fax:
Practice Address - Street 1:17 N MILES AVE
Practice Address - Street 2:
Practice Address - City:HARDIN
Practice Address - State:MT
Practice Address - Zip Code:59034-2323
Practice Address - Country:US
Practice Address - Phone:406-665-2310
Practice Address - Fax:406-665-9238
Is Sole Proprietor?:No
Enumeration Date:2018-09-07
Last Update Date:2018-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-131606363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily