ELIZABETH ROSE LICHTSINN


Address: 3919 W Jefferson Blvd Ste 200, Fort Wayne, IN 46804-6811
Phone: 2604501313

ELIZABETH ROSE LICHTSINN (NPI# 1235780362) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1235780362
Entity Type Individual
Full Name ELIZABETH ROSE LICHTSINN
Credential NP-C
Practice Address 3919 W Jefferson Blvd Ste 200
Fort Wayne
IN 46804-6811
Practice Telephone 2604501313
Mailing Telephone 2604501313
Mailing Fax Number 3302828009
Enumeration Date 2019-09-20
Last Update Date 2020-07-01
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LF0000X Nurse Practitioner
Specialization: Family
71009392A IN Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
4180 Sage Bluff Xing, Fort Wayne, IN 468042363 2604437300
3919 W Jefferson Blvd Ste 200, Fort Wayne, IN 468046811 2604501313

Office Location

Street Address 3919 W JEFFERSON BLVD STE 200
City FORT WAYNE
State IN
Zip Code 46804-6811

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NPI Name Taxonomy Address Enumeration
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1083265433 Fort Wayne Endodontics Dentist 9407 Illinois Rd, Fort Wayne, IN 46804 2019-09-26
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1417446022 Mary Harrington Physical Therapist 3320 Copper Hill Run, Fort Wayne, IN 46804 2018-05-09
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Taxonomy Information

Taxonomy Code 363LF0000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Family

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
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1932725942 Health Essential LLC Nurse Practitioner 3030 Lake Ave Ste 14, Fort Wayne, IN 46805-5428 2020-06-25
1942824842 Carissa Miller Nurse Practitioner 707 Rollingwood Ln, Fort Wayne, IN 46845-1088 2020-06-05
1891329819 Jasmine Monae Tubbs Nurse Practitioner 875 Petal Way, Fort Wayne, IN 46816-8900 2020-02-28
1033676275 Amanda Warner Nurse Practitioner 2229 Woods Rd, Fort Wayne, IN 46818-9539 2019-02-25
1669940714 Brookelyn Agler Nurse Practitioner Summit Radiology, PC, 5001 Us Highway 30 W, Suite D, Fort Wayne, IN 46818-9701 2018-11-07
1346731908 Erin Nicole Zimmerman Nurse Practitioner 10170 Illinois Rd # 14, Fort Wayne, IN 46804 2018-05-19
1154710978 Julie Lombard Nurse Practitioner 7222 Engle Rd, Fort Wayne, IN 46804-2222 2015-01-16
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Competitor

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City FORT WAYNE
Zip Code 46804

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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