Provider Demographics
NPI:1760744080
Name:JARVIS, ELIZABETH H (MSN APN CNS)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:H
Last Name:JARVIS
Suffix:
Gender:F
Credentials:MSN APN CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:932 SPRUCE ST
Mailing Address - Street 2:
Mailing Address - City:SEBASTIAN
Mailing Address - State:FL
Mailing Address - Zip Code:32976-7324
Mailing Address - Country:US
Mailing Address - Phone:501-837-5379
Mailing Address - Fax:949-543-2914
Practice Address - Street 1:932 SPRUCE ST
Practice Address - Street 2:
Practice Address - City:SEBASTIAN
Practice Address - State:FL
Practice Address - Zip Code:32976-7324
Practice Address - Country:US
Practice Address - Phone:501-837-5379
Practice Address - Fax:949-543-2914
Is Sole Proprietor?:No
Enumeration Date:2012-06-12
Last Update Date:2022-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARSO1022364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health