Elizabeth J Nagle, FNP
Individual provider Active NPI Family Nurse Practitioner · Gualala, CA
NPI 1851379705 · NPPES record last updated Jan 27, 2016
Key facts
- NPI
- 1851379705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- ZZZ26736Z (CA)
- Practice address
- 46900 Ocean Dr
Gualala, CA 95445-8353 - Phone
- (707) 884-4005
- Fax
- (707) 884-4625
- NPI assigned
- Jan 1, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ZZZ26736Z | CA | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Regional Emergency Medical Group Inc | Past | Accepting new patients | |
| Marvin P Matlock M D Inc | Past | Accepting new patients | |
| Community Hospitalist Medical Group Inc. | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | ZZZ26736Z | CA | Yes |
Addresses
Primary practice location
46900 Ocean Dr
Gualala, CA 95445-8353
Mailing address
PO Box 1100
Gualala, CA 95445-1100
Phone (707) 884-4005
Other providers in Gualala, CA
- Lucinda Weaver Physical Therapy
- Jessica B Maness
- Peter W McCann
- Mendonoma Health Alliance
- Richard T Miner
- Robert Arnold Nelson
- Northern California Medical Assoc Inc
- James Edwin Platt
- Karenanne Leilani Radich
- Roberta U. Rams
All providers in Gualala, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 27, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.