Provider Demographics
NPI:1053075150
Name:BARGARDO, ELIZABETH ROSE (RN)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:ROSE
Last Name:BARGARDO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ELIZABETH
Other - Middle Name:ROSE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:409 FRANKLIN PIERCE HWY
Mailing Address - Street 2:
Mailing Address - City:BARRINGTON
Mailing Address - State:NH
Mailing Address - Zip Code:03825-7342
Mailing Address - Country:US
Mailing Address - Phone:603-781-5170
Mailing Address - Fax:
Practice Address - Street 1:30 HUNTER LN
Practice Address - Street 2:
Practice Address - City:CAMP HILL
Practice Address - State:PA
Practice Address - Zip Code:17011-2499
Practice Address - Country:US
Practice Address - Phone:800-748-3242
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-10-25
Last Update Date:2021-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH064005-21163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse