Provider Demographics
NPI:1174870117
Name:CEDRONE, ELIZABETH ANN BRISCOE (RPA-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN BRISCOE
Last Name:CEDRONE
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:ANN BRISCOE
Other - Last Name:BOWER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:1941 S IH 35
Mailing Address - Street 2:SUITE 101
Mailing Address - City:SAN MARCOS
Mailing Address - State:TX
Mailing Address - Zip Code:78666-6168
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1941 IH 35, SUITE 101
Practice Address - Street 2:SUITE 101
Practice Address - City:SAN MARCOS
Practice Address - State:TX
Practice Address - Zip Code:78666
Practice Address - Country:US
Practice Address - Phone:512-353-6425
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-09
Last Update Date:2016-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015848363AM0700X
TXPA0902363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical