Provider Demographics
NPI:1386260347
Name:MAICHE, ELIZABETH WARRINGTON (PA)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WARRINGTON
Last Name:MAICHE
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:LALAGE WARRINGTON
Other - Last Name:MAICHE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PA
Mailing Address - Street 1:113 MONTGOMERY DR
Mailing Address - Street 2:
Mailing Address - City:SALUDA
Mailing Address - State:NC
Mailing Address - Zip Code:28773-7787
Mailing Address - Country:US
Mailing Address - Phone:828-699-5076
Mailing Address - Fax:
Practice Address - Street 1:113 MONTGOMERY DR
Practice Address - Street 2:
Practice Address - City:SALUDA
Practice Address - State:NC
Practice Address - Zip Code:28773-7787
Practice Address - Country:US
Practice Address - Phone:828-699-5076
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC0010-08501363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical