Provider Demographics
NPI:1396258489
Name:SHITEMI, ELIZABETH JOY (RN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:JOY
Last Name:SHITEMI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JOY
Other - Last Name:CROSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:12 GRANT RD
Mailing Address - Street 2:
Mailing Address - City:NEWMARKET
Mailing Address - State:NH
Mailing Address - Zip Code:03857-2101
Mailing Address - Country:US
Mailing Address - Phone:603-205-3577
Mailing Address - Fax:
Practice Address - Street 1:29 MARKET SQ
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01905-2420
Practice Address - Country:US
Practice Address - Phone:603-205-3577
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-10
Last Update Date:2017-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN277235163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health