Provider Demographics
NPI:1356933204
Name:YAMAGUCHI, ELIZABETH (DNP, FNP, RN, BSN)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:
Last Name:YAMAGUCHI
Suffix:
Gender:F
Credentials:DNP, FNP, RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 N A W GRIMES BLVD STE 210
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78665-2424
Mailing Address - Country:US
Mailing Address - Phone:512-772-2929
Mailing Address - Fax:512-772-2929
Practice Address - Street 1:2200 N A W GRIMES BLVD STE 210
Practice Address - Street 2:
Practice Address - City:ROUND ROCK
Practice Address - State:TX
Practice Address - Zip Code:78665-2424
Practice Address - Country:US
Practice Address - Phone:512-772-2929
Practice Address - Fax:512-772-2929
Is Sole Proprietor?:No
Enumeration Date:2021-02-10
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1029907363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily