Provider Demographics
NPI:1801407796
Name:CHINLUND, ELISABETH MORLEY (ARNP)
Entity Type:Individual
Prefix:
First Name:ELISABETH
Middle Name:MORLEY
Last Name:CHINLUND
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:445 DELMAR TER S APT 5
Mailing Address - Street 2:
Mailing Address - City:SAINT PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33701-4653
Mailing Address - Country:US
Mailing Address - Phone:336-830-1684
Mailing Address - Fax:
Practice Address - Street 1:445 DELMAR TER S APT 5
Practice Address - Street 2:
Practice Address - City:SAINT PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33701-4653
Practice Address - Country:US
Practice Address - Phone:336-830-1684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-13
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11008767363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics