Provider Demographics
NPI:1720195233
Name:MOKROHISKY, ELIZABETH A (APN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:A
Last Name:MOKROHISKY
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANNE
Other - Last Name:NEUBER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2874 N CARSON ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89706-0251
Mailing Address - Country:US
Mailing Address - Phone:775-283-3096
Mailing Address - Fax:775-283-3091
Practice Address - Street 1:925 IRONWOOD DR
Practice Address - Street 2:SUITE 2108
Practice Address - City:MINDEN
Practice Address - State:NV
Practice Address - Zip Code:89423-5178
Practice Address - Country:US
Practice Address - Phone:775-445-7929
Practice Address - Fax:775-783-8889
Is Sole Proprietor?:No
Enumeration Date:2006-08-23
Last Update Date:2010-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVAPN001131363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCK476ZMedicare PIN