Basic Information
| Provider Information | |||||||||
| NPI: | 1366851313 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ELIZALDE | ||||||||
| FirstName: | NORA | ||||||||
| MiddleName: | PATRICIA | ||||||||
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| Credential: | CNM, WHNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 913041 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802913041 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6105945108 | ||||||||
| FaxNumber: | 6103631790 | ||||||||
| Practice Location | |||||||||
| Address1: | 505 N MAIN ST | ||||||||
| Address2: | |||||||||
| City: | ULYSSES | ||||||||
| State: | KS | ||||||||
| PostalCode: | 67880 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6203561261 | ||||||||
| FaxNumber: | 6203563846 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/04/2014 | ||||||||
| LastUpdateDate: | 07/20/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 367A00000X | AP129656 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 367A00000X | 149453 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife | 363LW0102X | 149452 | KS | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Women's Health | 367A00000X | 76551 | KS | Y | Physician Assistants & Advanced Practice Nursing Providers | Advanced Practice Midwife |
No ID Information.