Provider Demographics
NPI:1851751218
Name:CARUSO, ELIZABETH GOOTEE (NP-C)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:GOOTEE
Last Name:CARUSO
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:764 CONRAD ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70124-3561
Mailing Address - Country:US
Mailing Address - Phone:504-813-1574
Mailing Address - Fax:
Practice Address - Street 1:1315 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2406
Practice Address - Country:US
Practice Address - Phone:504-842-3567
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-28
Last Update Date:2016-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAAP08716363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS06357567Medicaid
LA2426184Medicaid
LA2426184Medicaid