Individual
DR. ELIZABETH JUSTINE NOURSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
725 UNIVERSITY BLVD, FAIRBORN, OH 45324
(937) 245-7200
Mailing address
744 MOHAWK ST, COLUMBUS, OH 43206-2111
(260) 450-8784
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
57.253352
OH
208000000X
Pediatrics Physician
57.253352
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/19/2021
Last updated
04/21/2025
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