Provider Demographics
NPI:1821335993
Name:CERCONE, ELIZABETH ANN (NP, RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANN
Last Name:CERCONE
Suffix:
Gender:F
Credentials:NP, RN
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Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:3505 DULUTH PARK LN STE 400
Mailing Address - Street 2:MAXA INTERNAL MEDICINE ASSOCIATES
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3203
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3505 DULUTH PARK LN STE 400
Practice Address - Street 2:MAXA INTERNAL MEDICINE ASSOCIATES
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-3203
Practice Address - Country:US
Practice Address - Phone:678-597-3180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-09
Last Update Date:2015-08-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN213895163W00000X, 363LF0000X
FL2727652163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse