Provider Demographics
NPI:1134580442
Name:KLEINFELDER, ELIZABETH BOYLE (CRNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:BOYLE
Last Name:KLEINFELDER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3551 DUNN RD STE 101
Mailing Address - Street 2:
Mailing Address - City:EASTOVER
Mailing Address - State:NC
Mailing Address - Zip Code:28312-8794
Mailing Address - Country:US
Mailing Address - Phone:717-636-3255
Mailing Address - Fax:
Practice Address - Street 1:3551 DUNN RD
Practice Address - Street 2:
Practice Address - City:EASTOVER
Practice Address - State:NC
Practice Address - Zip Code:28312
Practice Address - Country:US
Practice Address - Phone:910-483-6277
Practice Address - Fax:910-483-6369
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-14
Last Update Date:2018-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP015767363LA2100X
NC5008522363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care