Provider Demographics
NPI:1710271556
Name:CAUDILLO, ELIZABETH ERSKINE (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ERSKINE
Last Name:CAUDILLO
Suffix:
Gender:F
Credentials:PA
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Other - First Name:
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Mailing Address - Street 1:485 N KS HWY 2
Mailing Address - Street 2:
Mailing Address - City:ANTHONY
Mailing Address - State:KS
Mailing Address - Zip Code:67003-2526
Mailing Address - Country:US
Mailing Address - Phone:620-914-1200
Mailing Address - Fax:620-914-1257
Practice Address - Street 1:111 E SPRING AVE
Practice Address - Street 2:
Practice Address - City:CONWAY SPRINGS
Practice Address - State:KS
Practice Address - Zip Code:67031-3101
Practice Address - Country:US
Practice Address - Phone:620-456-2411
Practice Address - Fax:620-456-2495
Is Sole Proprietor?:No
Enumeration Date:2011-06-08
Last Update Date:2025-10-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
KS1501443363A00000X
OK1931363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant