Individual
ELIZABETH EDACHERIL POULOSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1041 KIRKPATRICK RD STE 100, BURLINGTON, NC 27215-8066
(336) 538-0565
Mailing address
1041 KIRKPATRICK RD STE 100, BURLINGTON, NC 27215-8066
(336) 538-0565
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5011182
NC
363LP2300X
Primary Care Nurse Practitioner
Primary
5011182
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5011182
NURSE PRACTITIONER APPROVAL TO PRACTICE
NC
Enumeration date
11/05/2018
Last updated
06/26/2024
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