Provider Demographics
NPI:1679227300
Name:CIRILLO, ELIZABETH R (CNM)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:R
Last Name:CIRILLO
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-578-5241
Mailing Address - Fax:859-442-0046
Practice Address - Street 1:1400 GRAND AVE
Practice Address - Street 2:
Practice Address - City:FORT THOMAS
Practice Address - State:KY
Practice Address - Zip Code:41071-2570
Practice Address - Country:US
Practice Address - Phone:859-578-5241
Practice Address - Fax:859-442-0046
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY4017717367A00000X
OHAPRN.CNM.0019482367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife