Basic Information
Provider Information
NPI: 1003804105
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: JAMES
FirstName: ELIZABETH
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3250 5TH AVE N
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 33713
CountryCode: US
TelephoneNumber: 7273845088
FaxNumber:  
Practice Location
Address1: 3250 5TH AVE N
Address2:  
City: ST PETERSBURG
State: FL
PostalCode: 33713
CountryCode: US
TelephoneNumber: 7273845088
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/12/2005
LastUpdateDate: 03/29/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XARNP9227692FLN Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 
363LX0001XARNP9227692FLY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology

No ID Information.


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