Provider Demographics
NPI:1922385749
Name:ASARE, ELIZABETH
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:
Last Name:ASARE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10545 BLAIR RD
Mailing Address - Street 2:
Mailing Address - City:MINT HILL
Mailing Address - State:NC
Mailing Address - Zip Code:28227-2800
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10545 BLAIR RD
Practice Address - Street 2:SUITE 1200
Practice Address - City:MINT HILL
Practice Address - State:NC
Practice Address - Zip Code:28227-2800
Practice Address - Country:US
Practice Address - Phone:704-863-9600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-11-08
Last Update Date:2019-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5005419363LF0000X
NC181451363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCNP3883Medicaid
NC1922385749Medicaid
NCNCA943EMedicare PIN
NCNCA943DMedicare PIN
NC1922385749Medicaid
NCNCA943GMedicare PIN
NCNCA943CMedicare PIN