Provider Demographics
NPI:1881004968
Name:HARI, ELISABETH C (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:ELISABETH
Middle Name:C
Last Name:HARI
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:MS
Other - First Name:ELISABETH
Other - Middle Name:C
Other - Last Name:D'SOUZA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:5708 MOUNTAIN BLUFF DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76179-7219
Mailing Address - Country:US
Mailing Address - Phone:661-606-4939
Mailing Address - Fax:
Practice Address - Street 1:1301 N SAGINAW BLVD
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:TX
Practice Address - Zip Code:76179-5095
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-04-29
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045450363LF0000X
CA95000238363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily