Provider Demographics
NPI:1841522109
Name:ANDERSON, ELIZABETH ELVIRIA (RN, BSN, CM, DN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ELVIRIA
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN, BSN, CM, DN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1852 PLEASANT VIEW RD
Mailing Address - Street 2:
Mailing Address - City:ADAMSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21710-9011
Mailing Address - Country:US
Mailing Address - Phone:301-874-2099
Mailing Address - Fax:301-874-2099
Practice Address - Street 1:1852 PLEASANT VIEW RD
Practice Address - Street 2:
Practice Address - City:ADAMSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21710-9011
Practice Address - Country:US
Practice Address - Phone:301-874-2099
Practice Address - Fax:301-874-2099
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-10
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR156712163W00000X, 163WA2000X, 163WC0400X, 163WC1500X, 163WC1600X, 163WG0000X, 163WM0705X
DCRN1004478163W00000X, 163WA2000X, 163WC0400X, 163WC1400X, 163WC1500X, 163WC1600X, 163WG0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health
No163W00000XNursing Service ProvidersRegistered Nurse
No163WA2000XNursing Service ProvidersRegistered NurseAdministrator
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WC1400XNursing Service ProvidersRegistered NurseCollege Health
No163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical