Individual provider Active NPI

Elizabeth Hainan, CRNP

  • Family Nurse Practitioner
  • Apollo, PA
National Provider Identifier
1780088534
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
SP014220 Issued in PA
Practice address
1080 Poke Run Church Rd
Apollo, PA 15613-9689
Phone
(724) 325-7526
NPI assigned
Oct 22, 2014
Last updated
Oct 22, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X SP014220 PA Primary

Addresses

Primary practice location

1080 Poke Run Church Rd
Apollo, PA 15613-9689

Mailing address

1080 Poke Run Church Rd
Apollo, PA 15613-9689
Phone (724) 325-7526

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, OR2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20141212000065 PA Practitioner - Nurse Practitioner 8022330505 Reassigns benefits to 2 organizations
Practice locations: Apollo, PA
I20200914002609 OR Practitioner - Nurse Practitioner 8022330505 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
SP014220PAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wellbe Senior Medical Group of Pennsylvania PC CurrentSince Oct 16, 2023 Accepting new patients
Wound Healing Solutions Pennsylvania and Delaware LLC CurrentSince Mar 22, 2021 Accepting new patients

Locations

225 W Washington St
Ste 1500
Chicago, IL 60606
Phone (312) 776-2422

600 Clements Bridge Rd
Barrington, NJ 08007
Phone (609) 268-5517

395 Middle Rd
Nanticoke, PA 18634
Phone (570) 735-2973

2630 Woodland Rd
Roslyn, PA 19001
Phone (215) 313-9358

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1780088534",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 POKE RUN CHURCH RD",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156139689",
            "telephone_number": "724-325-7526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 POKE RUN CHURCH RD",
            "city": "APOLLO",
            "state": "PA",
            "postal_code": "156139689",
            "telephone_number": "724-325-7526"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAINAN",
        "first_name": "ELIZABETH",
        "credential": "CRNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "PA",
            "license": "SP014220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Apollo, PA

Sources for this page

Verify at the official NPI Registry.