Provider Demographics
NPI:1538498399
Name:PRICE, ELIZABETH (ARNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:472 HOLLAND BROS RD
Mailing Address - Street 2:
Mailing Address - City:WOODBURN
Mailing Address - State:KY
Mailing Address - Zip Code:42170-9629
Mailing Address - Country:US
Mailing Address - Phone:270-776-6722
Mailing Address - Fax:
Practice Address - Street 1:510 WEST HWY 76
Practice Address - Street 2:
Practice Address - City:WHITE HOUSE
Practice Address - State:TN
Practice Address - Zip Code:37188
Practice Address - Country:US
Practice Address - Phone:615-581-5089
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-08
Last Update Date:2010-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY6244P363LF0000X
TNAPN0000015097363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily