Provider Demographics
NPI:1770219461
Name:THROOP, ELISABETH ANN (FNP-C)
Entity type:Individual
Prefix:
First Name:ELISABETH
Middle Name:ANN
Last Name:THROOP
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23796 ODELL RD
Mailing Address - Street 2:
Mailing Address - City:SAINT CROIX
Mailing Address - State:IN
Mailing Address - Zip Code:47576-9036
Mailing Address - Country:US
Mailing Address - Phone:812-843-3458
Mailing Address - Fax:
Practice Address - Street 1:5604 E WHITE OAK LN
Practice Address - Street 2:
Practice Address - City:MARENGO
Practice Address - State:IN
Practice Address - Zip Code:47140-8413
Practice Address - Country:US
Practice Address - Phone:812-365-3221
Practice Address - Fax:812-365-9502
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71012800A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300074848Medicaid