Provider Demographics
NPI:1922504208
Name:CROWNINSHIELD, ELSIE MURIEL
Entity Type:Individual
Prefix:DR
First Name:ELSIE
Middle Name:MURIEL
Last Name:CROWNINSHIELD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28367 BERYLWOOD PL
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91354-1515
Mailing Address - Country:US
Mailing Address - Phone:818-421-0735
Mailing Address - Fax:
Practice Address - Street 1:28367 BERYLWOOD PL
Practice Address - Street 2:
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91354-1515
Practice Address - Country:US
Practice Address - Phone:818-421-0735
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-04
Last Update Date:2018-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10930363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute CareGroup - Single Specialty