Provider Demographics
NPI:1366564593
Name:BOONE, ELIZABETH G (NP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:G
Last Name:BOONE
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:501 SUNSET LN
Mailing Address - Street 2:
Mailing Address - City:CULPEPER
Mailing Address - State:VA
Mailing Address - Zip Code:22701-3917
Mailing Address - Country:US
Mailing Address - Phone:540-829-4100
Mailing Address - Fax:540-829-5713
Practice Address - Street 1:1000 RIVER RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CONSHOHOCKEN
Practice Address - State:PA
Practice Address - Zip Code:19428-2439
Practice Address - Country:US
Practice Address - Phone:610-834-2828
Practice Address - Fax:610-834-2862
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2008-02-26
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0001132310363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP15533Medicare UPIN