Individual
ELIZABETH ANN PAVAO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP, RNFA
Contact information
Practice address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Mailing address
22 BRAMHALL ST, PORTLAND, ME 04102-3134
(207) 662-2934
(207) 662-6389
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN45048
ME
363LA2100X
Acute Care Nurse Practitioner
11680
CT
363LF0000X
Family Nurse Practitioner
Primary
CNP81333
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283620099
—
ME
05
—
30343076
—
NH
Enumeration date
09/06/2006
Last updated
09/24/2024
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