MS. DEENA R ELIZALDE (NPI# 1720172539) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720172539 |
| Entity Type | Individual |
| Full Name | MS. DEENA R ELIZALDE |
| Credential | FNP |
| Practice Address |
1811 Charlton Ct Goshen IN 46526-6464 |
| Practice Telephone | 5745348200 |
| Practice Fax Number | 5745340411 |
| Mailing Telephone | 5745348200 |
| Mailing Fax Number | 5745340411 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2007-09-05 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
71001310A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
622215 | TX | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1811 CHARLTON CT |
| City | GOSHEN |
| State | IN |
| Zip Code | 46526-6464 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811906084 | Timothy Dwayne Thut | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2006-08-05 |
| 1346690773 | Michael Brian Fecher | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2016-06-16 |
| 1023427598 | Arin Miller | Nurse Practitioner | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2014-08-08 |
| 1124258124 | Casilda Cabral Chenier | Physician Assistant | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2009-07-24 |
| 1528296373 | Kathryn Elaine Michalczyk | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2009-06-30 |
| 1598923997 | Amanda Dianne Schmidt | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2008-06-02 |
| 1447458096 | Bethany Ann Wait | General Practice | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2007-07-05 |
| 1255402392 | Lane C. Reed | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2006-11-12 |
| 1033292735 | Goshen Family Physicians | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2006-10-24 |
| 1669566246 | Barbara Joan Meyer | Family Medicine | 1811 Charlton Ct, Goshen, IN 46526-6464 | 2006-10-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134631344 | Heidi Kauffmann | Social Worker | 2606 Peddler's Village Rd. Suite 210, Goshen, IN 46526 | 2017-10-27 |
| 1952812034 | Blue Diamond Villas | Skilled Nursing Facility | 1510 Sandpiper Lane, Goshen, IN 46526 | 2017-10-17 |
| 1578086534 | Anthony Escotto | Physical Therapist | 223 North Chicago Avenue, Goshen, IN 46526 | 2017-07-21 |
| 1831544774 | April Noelle Hart | Registered Nurse | 2606 Peddlers Village Rd., Suite 215, Goshen, IN 46526 | 2016-04-28 |
| 1639530108 | Amanda Miller | Physical Therapy Assistant | 114 Watertower Court, Goshen, IN 46526 | 2016-03-11 |
| 1720486095 | Gloria White | Pharmacist | 4430 Elkhart Road, C/o Walgreens, Goshen, IN 46526 | 2014-12-18 |
| 1184982472 | Dianna Christine Hoover | Occupational Therapist | 1627 Autumn Blaze Lane, Goshen, IN 46526 | 2012-04-24 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1659670685 | Michiana Eye Center LLC | Optometrist | 1747 Stafford Ct, Goshen, IN 46526 | 2011-03-16 |
| 1467759001 | Natasha Candace Pontius | Occupational Therapy Assistant | 2400 College Aveune, Goshen, IN 46526 | 2011-02-17 |
| Find all providers in zip 46526 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306465331 | Brittaney Lee Torchio | Nurse Practitioner | 5 Coates Dr Ste 2, Goshen, NY 10924-6747 | 2020-04-09 |
| 1184262883 | Guadalupe Smith | Nurse Practitioner | 1007 Harmony Ln, Goshen, KY 40026-9539 | 2019-12-13 |
| 1134761182 | Mariya Dagnese | Nurse Practitioner | 30 Hatfield Lane, St 105, Goshen, NY 10924-6768 | 2019-10-10 |
| 1962930180 | Angela Marie Mattern | Nurse Practitioner | 2012 S Main St Ste C, Goshen, IN 46526-5200 | 2017-06-01 |
| 1720453392 | Joan Susan Wahl | Nurse Practitioner | 6722 State Route 132 Ste A, Goshen, OH 45122-9346 | 2015-12-08 |
| 1164814315 | Siena Lecorps | Nurse Practitioner | 30 Hatfield Ln Ste 208, Goshen, NY 10924-6768 | 2015-02-25 |
| 1801152095 | Jami K Kamp | Nurse Practitioner | 1855 S. Main Street, Suite A, Heart & Vascular Center, Goshen, IN 46526-4723 | 2012-04-02 |
| 1629361357 | Amy Rebecca Pointon | Nurse Practitioner | 1615 Winsted Dr Ste 1, Goshen, IN 46526 | 2011-05-27 |
| 1679808919 | Ram Khattri Chettri | Nurse Practitioner | 1855 S Main Street, Suite A, Heart & Vascular Center, Goshen, IN 46526-4723 | 2009-10-05 |
| 1336196591 | Carolin K. Marzouk | Nurse Practitioner | 213 Middlebury Street, Goshen, IN 46528 | 2006-05-31 |
| Find all providers in GOSHEN | ||||
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| 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.