Provider Demographics
NPI:1164233110
Name:LIZAIRE, ELVIRE A (RN, BSN)
Entity type:Individual
Prefix:MRS
First Name:ELVIRE
Middle Name:A
Last Name:LIZAIRE
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NC
Mailing Address - Zip Code:27536-5056
Mailing Address - Country:US
Mailing Address - Phone:850-357-6123
Mailing Address - Fax:
Practice Address - Street 1:711 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NC
Practice Address - Zip Code:27536-5056
Practice Address - Country:US
Practice Address - Phone:850-357-6123
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-17
Last Update Date:2025-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCRN273173163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health