Basic Information
| Provider Information | |||||||||
| NPI: | 1255912127 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | 1255912127 | ||||||||
| OrganizationName: | |||||||||
| LastName: | ANDREWS | ||||||||
| FirstName: | LIZABETH | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | P.A.-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | P.O. BOX 94532 | ||||||||
| Address2: | |||||||||
| City: | NORTH LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 72190 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5017650262 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 9601 BAPTIST HEALTH DR STE 860 | ||||||||
| Address2: | |||||||||
| City: | LITTLE ROCK | ||||||||
| State: | AR | ||||||||
| PostalCode: | 722056375 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5019757455 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/03/2010 | ||||||||
| LastUpdateDate: | 07/05/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 07/05/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363A00000X | PA977 | AR | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant |
ID Information
| ID | Type | State | Issuer | Description | 268244795 | 05 | AR | MEDICAID |