Provider Demographics
NPI:1043210032
Name:SIPALA, ELIZABETH PILKINGTON (CRNP)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:PILKINGTON
Last Name:SIPALA
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8923 ORCHARD DR
Mailing Address - Street 2:
Mailing Address - City:CHESTERTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21620-3407
Mailing Address - Country:US
Mailing Address - Phone:410-778-0037
Mailing Address - Fax:
Practice Address - Street 1:6602 CHURCH HILL RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CHESTERTOWN
Practice Address - State:MD
Practice Address - Zip Code:21620-2310
Practice Address - Country:US
Practice Address - Phone:410-778-0300
Practice Address - Fax:410-778-0351
Is Sole Proprietor?:No
Enumeration Date:2005-07-30
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR080623363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD156031000Medicaid
R91367Medicare UPIN
MD552LMedicare ID - Type Unspecified