Basic Information
| Provider Information | |||||||||
| NPI: | 1295194967 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ANDRUS | ||||||||
| FirstName: | ELIZABETH | ||||||||
| MiddleName: | COUCH | ||||||||
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| Credential: | FNP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 18 MELVILLE GLEN PL | ||||||||
| Address2: | |||||||||
| City: | CONROE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 773844800 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8329287854 | ||||||||
| FaxNumber: | 2815370315 | ||||||||
| Practice Location | |||||||||
| Address1: | 2255 E MOSSY OAKS RD STE 680 | ||||||||
| Address2: | |||||||||
| City: | SPRING | ||||||||
| State: | TX | ||||||||
| PostalCode: | 77389 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2815370300 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/23/2016 | ||||||||
| LastUpdateDate: | 01/18/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 01/18/2022 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363L00000X | AP130199 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner |
No ID Information.