Provider Demographics
NPI:1871658088
Name:ELIZABETH Q CAULEY
Entity Type:Organization
Organization Name:ELIZABETH Q CAULEY
Other - Org Name:GUAM NURSING SERVICES
Other - Org Type:Other Name
Authorized Official - Title/Position:CLINICAL PROGRAM COORDINATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:LEONORA
Authorized Official - Middle Name:GALLETES
Authorized Official - Last Name:URBANO
Authorized Official - Suffix:
Authorized Official - Credentials:MSN RN CHCQM
Authorized Official - Phone:671-649-4000
Mailing Address - Street 1:PO BOX 8365
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96931-8365
Mailing Address - Country:US
Mailing Address - Phone:671-649-4000
Mailing Address - Fax:671-646-0150
Practice Address - Street 1:285 FARENHOLT AVE
Practice Address - Street 2:SUITE C311
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913
Practice Address - Country:US
Practice Address - Phone:671-649-4000
Practice Address - Fax:671-646-0150
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2007-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GU13200602117001251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
GU657002Medicare ID - Type Unspecified