Basic Information
| Provider Information | |||||||||
| NPI: | 1689748527 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARMICHAEL | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | KATHLEEN | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MSN, FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1088 BROWN AVE | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287861918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284562828 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1088 BROWN AVE | ||||||||
| Address2: | |||||||||
| City: | WAYNESVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 287861918 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8284562828 | ||||||||
| FaxNumber: | 8284568903 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/20/2006 | ||||||||
| LastUpdateDate: | 05/04/2015 | ||||||||
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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 | 163W00000X | 0001136005 | VA | N | Nursing Service Providers | Registered Nurse | 163W00000X | 101983 | NC | N | Nursing Service Providers | Registered Nurse | 363LF0000X | 0024166648 | VA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LF0000X | 5004639 | NC | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
| ID | Type | State | Issuer | Description | 7004235 | 05 | NC | MEDICAID |