Provider Demographics
NPI:1023144920
Name:CATTELL, ELIZABETH (RN, ACNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:CATTELL
Suffix:
Gender:F
Credentials:RN, ACNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11550 INDIAN HILLS RD STE 371
Mailing Address - Street 2:
Mailing Address - City:MISSION HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:91345-1252
Mailing Address - Country:US
Mailing Address - Phone:818-365-1194
Mailing Address - Fax:
Practice Address - Street 1:11550 INDIAN HILLS RD STE 371
Practice Address - Street 2:
Practice Address - City:MISSION HILLS
Practice Address - State:CA
Practice Address - Zip Code:91345-1252
Practice Address - Country:US
Practice Address - Phone:818-365-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2019-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARN281730363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP19839Medicare UPIN
CAEX667ZMedicare PIN