Provider Demographics
NPI:1063144004
Name:DIPAOLA, ELIZABETH A (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:DIPAOLA
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 S BAYLIS ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21224-5201
Mailing Address - Country:US
Mailing Address - Phone:443-994-5152
Mailing Address - Fax:
Practice Address - Street 1:9256 BENDIX RD STE 200A
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21045-1848
Practice Address - Country:US
Practice Address - Phone:443-542-0505
Practice Address - Fax:443-542-0506
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR228302363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily