Provider Demographics
NPI:1982208484
Name:DA SILVA, ELIZABETH (APRN)
Entity Type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:DA SILVA
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1243 MINERAL SPRING AVE UNIT 7
Mailing Address - Street 2:
Mailing Address - City:NORTH PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02904-4636
Mailing Address - Country:US
Mailing Address - Phone:401-388-3899
Mailing Address - Fax:401-340-1831
Practice Address - Street 1:1243 MINERAL SPRING AVE UNIT 7
Practice Address - Street 2:
Practice Address - City:NORTH PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02904-4636
Practice Address - Country:US
Practice Address - Phone:401-388-3899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-24
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN02191363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
15018818OtherCAQH