Provider Demographics
NPI:1013303957
Name:GALVIN, ELIZABETH MEADOWS (APRN-CNP)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MEADOWS
Last Name:GALVIN
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:DR
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:FITZSIMONS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:200 MILL RD STE 180
Mailing Address - Street 2:
Mailing Address - City:FAIRHAVEN
Mailing Address - State:MA
Mailing Address - Zip Code:02719-5255
Mailing Address - Country:US
Mailing Address - Phone:508-973-2000
Mailing Address - Fax:508-973-2001
Practice Address - Street 1:208 MILL RD
Practice Address - Street 2:STE 101
Practice Address - City:FAIRHAVEN
Practice Address - State:MA
Practice Address - Zip Code:02719-5208
Practice Address - Country:US
Practice Address - Phone:508-758-3781
Practice Address - Fax:508-758-4455
Is Sole Proprietor?:No
Enumeration Date:2015-04-07
Last Update Date:2016-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2258975363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110103647AMedicaid
MA110103647AMedicaid