Provider Demographics
NPI:1598346348
Name:FAIR, ELIZABETH J (NBC-HWC)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:FAIR
Suffix:
Gender:F
Credentials:NBC-HWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BURNS CT
Mailing Address - Street 2:
Mailing Address - City:HILTON HEAD ISLAND
Mailing Address - State:SC
Mailing Address - Zip Code:29928-5134
Mailing Address - Country:US
Mailing Address - Phone:859-321-2444
Mailing Address - Fax:
Practice Address - Street 1:2 BURNS CT
Practice Address - Street 2:
Practice Address - City:HILTON HEAD ISLAND
Practice Address - State:SC
Practice Address - Zip Code:29928-5134
Practice Address - Country:US
Practice Address - Phone:859-321-2444
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-04-14
Last Update Date:2021-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator