Provider Demographics
NPI:1699735811
Name:NARDI, ELIZABETH A (RNCPNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:NARDI
Suffix:
Gender:F
Credentials:RNCPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 OSTROM RD
Mailing Address - Street 2:
Mailing Address - City:EAST FALMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02536-7732
Mailing Address - Country:US
Mailing Address - Phone:508-540-6539
Mailing Address - Fax:
Practice Address - Street 1:15 BRAMBLEBUSH PARK
Practice Address - Street 2:
Practice Address - City:FALMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02540-2325
Practice Address - Country:US
Practice Address - Phone:508-548-6969
Practice Address - Fax:508-540-2793
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA131652363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MANP9968OtherBLUE SHIELD