Provider Demographics
NPI:1831317809
Name:ALVERSON, ELISE MARTA (APRN, MSN, FNP)
Entity Type:Individual
Prefix:MRS
First Name:ELISE
Middle Name:MARTA
Last Name:ALVERSON
Suffix:
Gender:F
Credentials:APRN, MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 WOODSIDE DR
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-7162
Mailing Address - Country:US
Mailing Address - Phone:219-879-8866
Mailing Address - Fax:
Practice Address - Street 1:1406 LAPORTE AVE
Practice Address - Street 2:VALPARAISO UNIVERSITY HEALTH CENTER
Practice Address - City:VALPARAISO
Practice Address - State:IN
Practice Address - Zip Code:46383
Practice Address - Country:US
Practice Address - Phone:219-464-5060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000533A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily