Provider Demographics
NPI:1194744912
Name:NATION, ELIZABETH MARTHA (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARTHA
Last Name:NATION
Suffix:
Gender:F
Credentials:NP
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Other - Credentials:
Mailing Address - Street 1:630 PLANTATION ST
Mailing Address - Street 2:WOT 12TH FL
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01605-2038
Mailing Address - Country:US
Mailing Address - Phone:508-460-3050
Mailing Address - Fax:508-460-3226
Practice Address - Street 1:24 NEWTON ST
Practice Address - Street 2:
Practice Address - City:SOUTHBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01772-1215
Practice Address - Country:US
Practice Address - Phone:508-460-3050
Practice Address - Fax:508-460-3226
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2015-09-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MARN153400363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0329461Medicaid
MA0329461Medicaid
MA0329461Medicaid