Provider Demographics
NPI:1356618748
Name:BUCHANAN, ELISABETH ANNE (APRN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:ELISABETH
Middle Name:ANNE
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 OCEANGATE
Mailing Address - Street 2:#100
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4317
Mailing Address - Country:US
Mailing Address - Phone:562-435-3666
Mailing Address - Fax:562-276-4825
Practice Address - Street 1:5605 N. MACARTHUR BL.
Practice Address - Street 2:#400
Practice Address - City:IRVING
Practice Address - State:TX
Practice Address - Zip Code:75038-2617
Practice Address - Country:US
Practice Address - Phone:888-562-5442
Practice Address - Fax:562-276-4825
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003637A363LP2300X
TXAP125928363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care