Provider Demographics
NPI:1962744615
Name:SJULANDER, ELIZABETH (RN, BSN)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:SJULANDER
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 69
Mailing Address - Street 2:
Mailing Address - City:WATERBORO
Mailing Address - State:ME
Mailing Address - Zip Code:04087-0069
Mailing Address - Country:US
Mailing Address - Phone:207-247-9000
Mailing Address - Fax:207-247-6109
Practice Address - Street 1:802 MAIN STREET
Practice Address - Street 2:
Practice Address - City:WATERBORO
Practice Address - State:ME
Practice Address - Zip Code:04087-0069
Practice Address - Country:US
Practice Address - Phone:207-247-9000
Practice Address - Fax:207-247-6109
Is Sole Proprietor?:No
Enumeration Date:2013-03-20
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MER044015163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health