Provider Demographics
NPI:1487979423
Name:ENGELMAN, ELIZABETH (RN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:
Last Name:ENGELMAN
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 1:3419 KITE ST
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-4710
Mailing Address - Country:US
Mailing Address - Phone:619-556-8103
Mailing Address - Fax:
Practice Address - Street 1:3419 KITE ST
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-4710
Practice Address - Country:US
Practice Address - Phone:619-556-8103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00139430163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care