Provider Demographics
NPI:1285697813
Name:GUILFOYLE, ELIZABETH RICHEY (MSN, APRN, FNP, BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:RICHEY
Last Name:GUILFOYLE
Suffix:
Gender:F
Credentials:MSN, APRN, FNP, BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1930 GRANDIN RD SW
Mailing Address - Street 2:
Mailing Address - City:ROANOKE
Mailing Address - State:VA
Mailing Address - Zip Code:24015-2804
Mailing Address - Country:US
Mailing Address - Phone:540-342-0016
Mailing Address - Fax:540-342-3322
Practice Address - Street 1:1633 SALEM AVE SW
Practice Address - Street 2:
Practice Address - City:ROANOKE
Practice Address - State:VA
Practice Address - Zip Code:24016-2722
Practice Address - Country:US
Practice Address - Phone:540-857-7284
Practice Address - Fax:540-857-6469
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0017001163363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily