Provider Demographics
NPI:1609866805
Name:PRINTUP, ELIZABETH MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MARIE
Last Name:PRINTUP
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2015 MOUNT HOPE RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:NY
Mailing Address - Zip Code:14092-9762
Mailing Address - Country:US
Mailing Address - Phone:716-297-0310
Mailing Address - Fax:716-297-1562
Practice Address - Street 1:2015 MOUNT HOPE RD
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:NY
Practice Address - Zip Code:14092-9762
Practice Address - Country:US
Practice Address - Phone:716-297-0310
Practice Address - Fax:716-297-1562
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2012-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF330936-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily