Provider Demographics
NPI:1215281738
Name:WHITE, ELIZABETH ANN (RN, CNS (NURSE PRACT)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:WHITE
Suffix:
Gender:F
Credentials:RN, CNS (NURSE PRACT
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN
Other - Last Name:TILTON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:818 EAST 53RD STREET
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78751
Mailing Address - Country:US
Mailing Address - Phone:512-451-7361
Mailing Address - Fax:512-451-6175
Practice Address - Street 1:818 EAST 53RD STREET
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78751
Practice Address - Country:US
Practice Address - Phone:512-451-7361
Practice Address - Fax:512-451-6175
Is Sole Proprietor?:No
Enumeration Date:2012-11-06
Last Update Date:2012-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX710483364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist