Provider Demographics
NPI:1184419384
Name:MAYER, ELISABETH (PMHNP)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:
Last Name:MAYER
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 THE ESPLANADE N APT 403
Mailing Address - Street 2:
Mailing Address - City:VENICE
Mailing Address - State:FL
Mailing Address - Zip Code:34285-1528
Mailing Address - Country:US
Mailing Address - Phone:314-856-2942
Mailing Address - Fax:
Practice Address - Street 1:421 COMMERCIAL CT STE B
Practice Address - Street 2:
Practice Address - City:VENICE
Practice Address - State:FL
Practice Address - Zip Code:34292-1656
Practice Address - Country:US
Practice Address - Phone:396-906-9062
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-10
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11038830363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health