Provider Demographics
NPI:1801659826
Name:STANLEY, ELIZABETH (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:STANLEY
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 KV ROAD
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:VA
Mailing Address - Zip Code:23974-2016
Mailing Address - Country:US
Mailing Address - Phone:804-310-2774
Mailing Address - Fax:
Practice Address - Street 1:13855 COURTHOUSE RD
Practice Address - Street 2:
Practice Address - City:DINWIDDIE
Practice Address - State:VA
Practice Address - Zip Code:23841-2254
Practice Address - Country:US
Practice Address - Phone:804-469-3731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-01
Last Update Date:2024-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024189395363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily