Provider Demographics
NPI:1548623283
Name:SLAVINSKAS, ELIZABETH ARLENE (RN, FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ARLENE
Last Name:SLAVINSKAS
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:MRS
Other - First Name:ELIZABETH
Other - Middle Name:ARLENE
Other - Last Name:ANDRYSIAK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, FNP-BC
Mailing Address - Street 1:22818 OLD US 20
Mailing Address - Street 2:
Mailing Address - City:ELKHART
Mailing Address - State:IN
Mailing Address - Zip Code:46516-9150
Mailing Address - Country:US
Mailing Address - Phone:574-389-1231
Mailing Address - Fax:574-389-1232
Practice Address - Street 1:211 N EDDY ST
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-2808
Practice Address - Country:US
Practice Address - Phone:574-237-9231
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28193462A163WE0003X
IN71006187A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WE0003XNursing Service ProvidersRegistered NurseEmergency