Individual
MS. ELIZABETH ANNE SPAIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3000 GRAND AVE APT 801, DES MOINES, IA 50312-4263
(515) 360-8607
Mailing address
PO BOX 65874, WEST DES MOINES, IA 50265-0874
(515) 360-8607
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
P36621
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1801122676
BLUE CROSS BLUE SHIELD
IA
05
—
1801122676
—
IA
Enumeration date
10/28/2009
Last updated
06/12/2021
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