Provider Demographics
NPI:1174938641
Name:POUWELS, ELIZABETH JOANNE (RN)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:JOANNE
Last Name:POUWELS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 WATER ST
Mailing Address - Street 2:
Mailing Address - City:ELLSWORTH
Mailing Address - State:ME
Mailing Address - Zip Code:04605-2116
Mailing Address - Country:US
Mailing Address - Phone:207-667-5357
Mailing Address - Fax:
Practice Address - Street 1:52 CHRISTIAN RIDGE RD
Practice Address - Street 2:
Practice Address - City:ELLSWORTH
Practice Address - State:ME
Practice Address - Zip Code:04605-3210
Practice Address - Country:US
Practice Address - Phone:207-610-8025
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-24
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN59727163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse