Provider Demographics
NPI:1427309442
Name:HERRON, ELIZABETH MAY (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:MAY
Last Name:HERRON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:513 GEIGER AVE SW
Mailing Address - Street 2:
Mailing Address - City:MASSILLON
Mailing Address - State:OH
Mailing Address - Zip Code:44647-7838
Mailing Address - Country:US
Mailing Address - Phone:330-949-4171
Mailing Address - Fax:
Practice Address - Street 1:513 GEIGER AVE SW
Practice Address - Street 2:
Practice Address - City:MASSILLON
Practice Address - State:OH
Practice Address - Zip Code:44647-7838
Practice Address - Country:US
Practice Address - Phone:330-949-4171
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN.383723-163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse