Provider Demographics
NPI:1851302970
Name:ARCHAMBAULT, ELIZABETH M (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:M
Last Name:ARCHAMBAULT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 TAUNTON AVE
Mailing Address - Street 2:
Mailing Address - City:NORTON
Mailing Address - State:MA
Mailing Address - Zip Code:02766-2707
Mailing Address - Country:US
Mailing Address - Phone:508-285-9500
Mailing Address - Fax:508-285-3388
Practice Address - Street 1:14 TAUNTON AVE
Practice Address - Street 2:
Practice Address - City:NORTON
Practice Address - State:MA
Practice Address - Zip Code:02766-2707
Practice Address - Country:US
Practice Address - Phone:508-285-9500
Practice Address - Fax:508-285-3388
Is Sole Proprietor?:No
Enumeration Date:2006-08-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA201848363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP2985OtherMABC
MANP2985Medicare ID - Type Unspecified