Provider Demographics
NPI:1205511433
Name:LAND, ELIZABETH L (DNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:L
Last Name:LAND
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:L
Other - Last Name:EARLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4301 W MARKHAM ST # 783
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-7101
Mailing Address - Country:US
Mailing Address - Phone:501-686-8000
Mailing Address - Fax:501-526-5148
Practice Address - Street 1:2 SHACKLEFORD WEST BLVD
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72211-3755
Practice Address - Country:US
Practice Address - Phone:501-614-2663
Practice Address - Fax:501-614-2669
Is Sole Proprietor?:No
Enumeration Date:2023-06-15
Last Update Date:2023-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR225014363LG0600X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology