Provider Demographics
NPI:1447908157
Name:HEWITT, ELIZABETH MARY (FNP-C)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:MARY
Last Name:HEWITT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10011 CHARIOT TRL
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78254-5921
Mailing Address - Country:US
Mailing Address - Phone:210-667-6324
Mailing Address - Fax:
Practice Address - Street 1:6712 N NEW BRAUNFELS AVE
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-3830
Practice Address - Country:US
Practice Address - Phone:210-617-5585
Practice Address - Fax:210-617-5594
Is Sole Proprietor?:No
Enumeration Date:2022-03-11
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1072810363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily