Provider Demographics
NPI:1578582730
Name:DOLFIE, ELIZABETH KAY (APN BC)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:KAY
Last Name:DOLFIE
Suffix:
Gender:F
Credentials:APN BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 CARRIAGE DR
Mailing Address - Street 2:
Mailing Address - City:CROSSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:38555-5866
Mailing Address - Country:US
Mailing Address - Phone:931-787-8248
Mailing Address - Fax:931-787-8248
Practice Address - Street 1:1801 HICKMAN RD
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-1597
Practice Address - Country:US
Practice Address - Phone:515-282-2200
Practice Address - Fax:515-282-3589
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-19
Last Update Date:2018-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7590363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3631320Medicaid
TN4050355OtherBCBS
TN4050355OtherBCBS
TN3631320Medicare ID - Type Unspecified