Provider Demographics
NPI:1427058007
Name:GEDEN, ELIZABETH A (FNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:A
Last Name:GEDEN
Suffix:
Gender:F
Credentials:FNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1001 W WORLEY ST
Mailing Address - Street 2:FAMILY HEALTH CENTER OF BOONE COUNTY
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65203-2037
Mailing Address - Country:US
Mailing Address - Phone:573-214-2314
Mailing Address - Fax:573-607-2885
Practice Address - Street 1:1001 W WORLEY ST
Practice Address - Street 2:FAMILY HEALTH CENTER OF BOONE COUNTY
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65203-2037
Practice Address - Country:US
Practice Address - Phone:573-214-2314
Practice Address - Fax:573-607-2885
Is Sole Proprietor?:No
Enumeration Date:2005-07-26
Last Update Date:2019-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MO056827363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO428575427Medicaid
MO428575401Medicaid