Provider Demographics
NPI:1316615792
Name:EMDEN, ELIZABETH (RN, BSN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:EMDEN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3319 BAYSHORE BLVD
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33629-8899
Mailing Address - Country:US
Mailing Address - Phone:813-839-5371
Mailing Address - Fax:813-839-1486
Practice Address - Street 1:3319 BAYSHORE BLVD
Practice Address - Street 2:
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33629-8899
Practice Address - Country:US
Practice Address - Phone:813-839-5371
Practice Address - Fax:813-839-1486
Is Sole Proprietor?:No
Enumeration Date:2021-09-01
Last Update Date:2021-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9528234163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool