Individual
ELIZABETH FAY WASYLOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1022 COUNTY ROAD 28, SCOTTSBORO, AL 35768-6458
(256) 609-8023
Mailing address
1022 COUNTY ROAD 28, SCOTTSBORO, AL 35768-6458
(256) 609-8023
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1-081299
AL
363LA2100X
Acute Care Nurse Practitioner
27528
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1-081299
NURSING LICENSE
AL
01
—
2019056163
ANCC
—
Enumeration date
02/15/2020
Last updated
12/14/2021
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