Provider Demographics
NPI:1831281666
Name:KRALL, ELIZABETH ANNETTE (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ANNETTE
Last Name:KRALL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:542 MIDLAND TRL
Mailing Address - Street 2:
Mailing Address - City:HURRICANE
Mailing Address - State:WV
Mailing Address - Zip Code:25526-1628
Mailing Address - Country:US
Mailing Address - Phone:304-562-3506
Mailing Address - Fax:
Practice Address - Street 1:9 COURTHOUSE DR
Practice Address - Street 2:
Practice Address - City:WINFIELD
Practice Address - State:WV
Practice Address - Zip Code:25213-9347
Practice Address - Country:US
Practice Address - Phone:304-586-0500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV58906163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV9702087000Medicaid