Provider Demographics
NPI:1366764805
Name:TRUMAN, ELIZABETH LEASK (LPN)
Entity type:Individual
Prefix:MR
First Name:ELIZABETH
Middle Name:LEASK
Last Name:TRUMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2056 W ELM ST
Mailing Address - Street 2:
Mailing Address - City:ONEIDA
Mailing Address - State:NY
Mailing Address - Zip Code:13421-3006
Mailing Address - Country:US
Mailing Address - Phone:315-569-7647
Mailing Address - Fax:
Practice Address - Street 1:2056 W ELM ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:NY
Practice Address - Zip Code:13421-3006
Practice Address - Country:US
Practice Address - Phone:315-569-7647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255478164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse