Individual
ELIZABETH R BACCHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
2256 GILMER AVE, TALLASSEE, AL 36078-7114
(334) 567-8633
Mailing address
PO BOX 130, WETUMPKA, AL 36092-0003
(334) 514-3821
(334) 514-3686
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-114945
AL
Other
Enumeration date
01/19/2015
Last updated
01/27/2021
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