Provider Demographics
NPI:1447825930
Name:MOATS, ELIZABETH JANE
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:JANE
Last Name:MOATS
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ELIZABETH
Other - Middle Name:JANE
Other - Last Name:GILLIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:92 ENGLAND CEMETERY RD
Mailing Address - Street 2:
Mailing Address - City:MOATSVILLE
Mailing Address - State:WV
Mailing Address - Zip Code:26405-8497
Mailing Address - Country:US
Mailing Address - Phone:304-457-3295
Mailing Address - Fax:
Practice Address - Street 1:92 ENGLAND CEMETERY RD
Practice Address - Street 2:
Practice Address - City:MOATSVILLE
Practice Address - State:WV
Practice Address - Zip Code:26405-8497
Practice Address - Country:US
Practice Address - Phone:304-457-3295
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-26
Last Update Date:2023-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant