Provider Demographics
NPI:1578548293
Name:PRICE, LIZABETH MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:LIZABETH
Middle Name:MARIE
Last Name:PRICE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LIZABETH
Other - Middle Name:MARIE
Other - Last Name:CAHALAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50306-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-4973
Mailing Address - Fax:
Practice Address - Street 1:6200 AURORA AVE
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50322-2800
Practice Address - Country:US
Practice Address - Phone:515-270-1177
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-15
Last Update Date:2013-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA073115363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1476804Medicaid
IA1578548293Medicaid
IA4476804Medicaid
IA250175OtherMIDLANDS CHOICE
IA3476804Medicaid
IA2476804Medicaid
IA5476804Medicaid
IA4476804Medicaid
IA5476804Medicaid