Provider Demographics
NPI:1609880814
Name:SIGMUND, ELIZABETH C (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:C
Last Name:SIGMUND
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5665 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EAST PETERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17520-1513
Mailing Address - Country:US
Mailing Address - Phone:717-569-7011
Mailing Address - Fax:717-569-8694
Practice Address - Street 1:5665 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST PETERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17520-1513
Practice Address - Country:US
Practice Address - Phone:717-569-7011
Practice Address - Fax:717-569-8694
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PATP005399B363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA463839OtherHEALTH AMERICA
PA1558533OtherGATEWAY HEALTH PLAN
PA50064722OtherCAPITAL BLUE CROSS
P45338Medicare UPIN
PA052791GEDMedicare PIN