Provider Demographics
NPI:1821578121
Name:SABISTON-ROUSE, ELIZABETH ANN (FNP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:SABISTON-ROUSE
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:744 AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28504-8800
Mailing Address - Country:US
Mailing Address - Phone:252-523-0026
Mailing Address - Fax:252-523-1855
Practice Address - Street 1:416 MCCRAE ST
Practice Address - Street 2:
Practice Address - City:GRIFTON
Practice Address - State:NC
Practice Address - Zip Code:28530-9131
Practice Address - Country:US
Practice Address - Phone:252-524-4463
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-16
Last Update Date:2019-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5010862363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily