Provider Demographics
NPI:1538161542
Name:ANDREWS, ELIZABETH JENKINS (MSN, ARNP-BC, ACNP,G)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JENKINS
Last Name:ANDREWS
Suffix:
Gender:F
Credentials:MSN, ARNP-BC, ACNP,G
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:MEDICAL CENTER BLVD
Mailing Address - Street 2:
Mailing Address - City:WINSTON SALEM
Mailing Address - State:NC
Mailing Address - Zip Code:27157-0001
Mailing Address - Country:US
Mailing Address - Phone:336-716-5599
Mailing Address - Fax:336-716-3202
Practice Address - Street 1:1272 EAST ST
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28786-3437
Practice Address - Country:US
Practice Address - Phone:828-456-3511
Practice Address - Fax:828-456-3583
Is Sole Proprietor?:No
Enumeration Date:2005-08-10
Last Update Date:2016-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC600121/88415363LA2100X, 363LG0600X
NC600121363LA2100X, 363LG0600X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
192927OtherMEDCOST
SCNP0424Medicaid
7492901OtherAETNA
NC7004021Medicaid
NC8976002Medicaid
NC7004021Medicaid
NC2592828Medicare PIN
7492901OtherAETNA
SCS820235332Medicare ID - Type Unspecified