Provider Demographics
NPI:1841769510
Name:TRIZZINO, ELIZABETH MARIANNE
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARIANNE
Last Name:TRIZZINO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6415 BLACKBERRY LN
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6332
Mailing Address - Country:US
Mailing Address - Phone:563-370-7149
Mailing Address - Fax:
Practice Address - Street 1:6415 BLACKBERRY LN
Practice Address - Street 2:
Practice Address - City:BETTENDORF
Practice Address - State:IA
Practice Address - Zip Code:52722-6332
Practice Address - Country:US
Practice Address - Phone:563-370-7149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-24
Last Update Date:2018-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant