Provider Demographics
NPI:1689659468
Name:RADSLIFF, ELIZABETH CAROLYN (PNP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:CAROLYN
Last Name:RADSLIFF
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:8170 LAGUNA BLVD
Mailing Address - Street 2:SUITE 210
Mailing Address - City:ELK GROVE
Mailing Address - State:CA
Mailing Address - Zip Code:95758-7901
Mailing Address - Country:US
Mailing Address - Phone:916-691-5999
Mailing Address - Fax:
Practice Address - Street 1:10470 OLD PLACERVILLE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95827-2539
Practice Address - Country:US
Practice Address - Phone:800-470-0071
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2016-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA358283363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics