Individual
ELIZABETH Z THELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
374 HUDLOW RD, FOREST CITY, NC 28043-9444
(828) 245-0095
Mailing address
2051 CHARLIE HALL BLVD, CHARLESTON, SC 29414
(843) 573-2535
(843) 573-2534
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
5018499
NC
363LP0200X
Pediatric Nurse Practitioner
3357
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5018499
LICENSURE
NC
Enumeration date
09/17/2007
Last updated
02/05/2024
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