Individual provider · Type 1 NPI
Elyse Fairand
Gerontology Nurse Practitioner · Maywood, IL
NPI number
1376214262
Active
Practice location
2160 S 1st Ave
Maywood, IL 60153-3328
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | 209024276 (IL) |
| Gerontology Nurse Practitioner | 363LG0600X | AG06210021 (OH) |
Gerontology Nurse Practitioner: Definition to come...
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About NPI 1376214262
Elyse Fairand's National Provider Identifier is 1376214262, issued on Sep 22, 2021. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Maywood, IL. The record was last updated on May 19, 2022.