Provider Demographics
NPI:1558175661
Name:CAVAZOS, ELIZABETH C (ARNP PNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:CAVAZOS
Suffix:
Gender:F
Credentials:ARNP PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5908 160TH ST
Mailing Address - Street 2:
Mailing Address - City:THORNTON
Mailing Address - State:IA
Mailing Address - Zip Code:50479-8741
Mailing Address - Country:US
Mailing Address - Phone:309-751-7020
Mailing Address - Fax:
Practice Address - Street 1:5908 160TH ST
Practice Address - Street 2:
Practice Address - City:THORNTON
Practice Address - State:IA
Practice Address - Zip Code:50479-8741
Practice Address - Country:US
Practice Address - Phone:309-751-7020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAC182657363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics