Provider Demographics
NPI:1104472984
Name:SAUNCHES, ELIZABETH A (APN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:SAUNCHES
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:A
Other - Last Name:TIMMERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:308 SAINT JOSEPH DR
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-3506
Mailing Address - Country:US
Mailing Address - Phone:309-663-5050
Mailing Address - Fax:309-662-3401
Practice Address - Street 1:308 SAINT JOSEPH DR
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-3506
Practice Address - Country:US
Practice Address - Phone:309-663-5050
Practice Address - Fax:309-662-3401
Is Sole Proprietor?:No
Enumeration Date:2019-08-16
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209019714363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner