Individual provider Active NPI

Elizabeth Ann Nunziante, LPN

  • Licensed Practical Nurse
  • Crestline, OH
National Provider Identifier
1770769770
Registry record updated Jan 15, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Licensed Practical NurseTaxonomy code 164W00000X
License
PN096046 Issued in OH
Practice address
1766 State Route 61
Crestline, OH 44827-9786
Phone
(419) 683-0195
Fax
(419) 768-4043
NPI assigned
Jan 21, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 15, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN096046 OH Primary

Addresses

Primary practice location

1766 State Route 61
Crestline, OH 44827-9786

Mailing address

1766 State Route 61
Crestline, OH 44827-9786
Phone (419) 683-0195

Other identifiers 1

IdentifierTypeStateIssuer
2799619MedicaidOH

Medicare participation

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PN096046OHMDLicensed Practical Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1200873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1231977600000",
    "number": "1770769770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1766 STATE ROUTE 61",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448279786",
            "telephone_number": "419-683-0195",
            "fax_number": "419-768-4043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1766 STATE ROUTE 61",
            "city": "CRESTLINE",
            "state": "OH",
            "postal_code": "448279786",
            "telephone_number": "419-683-0195",
            "fax_number": "419-768-4043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NUNZIANTE",
        "first_name": "ELIZABETH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-01-21",
        "last_updated": "2009-01-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN096046",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2799619",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Crestline, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.