Provider Demographics
NPI:1154029528
Name:GILES, ELIZABETH KIRWIN (MSN, RN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:KIRWIN
Last Name:GILES
Suffix:
Gender:F
Credentials:MSN, RN, AGPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 BLEECKER ST APT 213W
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10012-1548
Mailing Address - Country:US
Mailing Address - Phone:805-722-8817
Mailing Address - Fax:
Practice Address - Street 1:77 BLEECKER ST APT 213W
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-1548
Practice Address - Country:US
Practice Address - Phone:805-722-8817
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-15
Last Update Date:2023-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF311153-01363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health