Provider Demographics
NPI:1639348758
Name:CANCRO, ELIZABETH TURNER (FNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:TURNER
Last Name:CANCRO
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 1:6800 LUCY CORR BLVD
Mailing Address - Street 2:
Mailing Address - City:CHESTERFIELD
Mailing Address - State:VA
Mailing Address - Zip Code:23832
Mailing Address - Country:US
Mailing Address - Phone:804-318-8584
Mailing Address - Fax:804-748-5054
Practice Address - Street 1:6800 LUCY CORR BLVD
Practice Address - Street 2:
Practice Address - City:CHESTERFIELD
Practice Address - State:VA
Practice Address - Zip Code:23832-6657
Practice Address - Country:US
Practice Address - Phone:804-318-8584
Practice Address - Fax:804-748-5054
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2011-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001078916163W00000X
VA0024078916363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163W00000XNursing Service ProvidersRegistered Nurse