Individual
ELIZABETH MAIKISCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3300 GALLOWS RD, FALLS CHURCH, VA 22042-3307
(517) 787-6440
(517) 787-4146
Mailing address
3100 SPRING FOREST RD, SUITE 130, RALEIGH, NC 27616-2880
(919) 882-0705
(919) 873-9821
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
0024127712
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020084100
—
MD
05
—
1548270820
—
VA
Enumeration date
08/09/2006
Last updated
04/29/2014
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