Provider Demographics
NPI:1851331375
Name:DRURY, ELIZABETH JULIA (NP)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JULIA
Last Name:DRURY
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:PO BOX 745
Mailing Address - Street 2:
Mailing Address - City:NEWCASTLE
Mailing Address - State:ME
Mailing Address - Zip Code:04553
Mailing Address - Country:US
Mailing Address - Phone:207-563-4146
Mailing Address - Fax:
Practice Address - Street 1:19 ST ANDREW'S LANE
Practice Address - Street 2:
Practice Address - City:BOOTHBAY HARBOR
Practice Address - State:ME
Practice Address - Zip Code:04538
Practice Address - Country:US
Practice Address - Phone:207-633-7820
Practice Address - Fax:207-633-7082
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2015-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81960363LP0808X
MERN54496163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME188898OtherLICENSE
MEE400190172Medicare PIN
ME001281102Medicare PIN
001281104Medicare PIN