Individual
ELIZABETH LASATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
26 WAGON JACK LN, ARCATA, CA 95521-9047
(707) 845-7630
Mailing address
26 WAGON JACK LN, ARCATA, CA 95521-9047
(707) 845-7630
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
843404
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
843404
BRN
CA
Enumeration date
11/17/2022
Last updated
11/17/2022
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