Elizabeth Sam, REGISTERED NURSE

Individual provider Active NPI Community Health Registered Nurse · Owyhee, NV

NPI 1235533910 · NPPES record last updated Oct 9, 2014

Key facts

NPI
1235533910
Entity type
Individual (NPI type 1)
Primary specialty
Community Health Registered Nurse 163WC1500X
License
R40849 (ND)
Practice address
1623 Hospital Loop
Owyhee, NV 89832-1200
Phone
(775) 757-2415
Fax
(775) 757-2066
NPI assigned
Oct 9, 2014
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
R40849NDMDCommunity Health Registered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Registered Nurse 163WC1500X R40849 ND Yes

Addresses

Primary practice location

1623 Hospital Loop
Owyhee, NV 89832-1200

Mailing address

PO Box 159
Owyhee, NV 89832-0159

Other identifiers

IdentifierTypeStateIssuer
R40849OtherNDRN LICENSE

Other providers in Owyhee, NV

All providers in Owyhee, NV · Community Health Registered Nurse in Nevada

Sources for this page

Verify at the official NPI Registry.