Bruton, Elizabeth R

Bruton, Elizabeth R is an individual health care provider with primary practice located at 9135 Sw Barnes Rd Ste 561 , Portland OR 97225-6643. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Bruton, Elizabeth R can be contacted via phone (503) 216-2339.

Contact Information

Primary practice address
9135 Sw Barnes Rd Ste 561 Portland OR 97225-6643
Phone: (503) 216-2339
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X R858140 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 201603382NP-PP Oregon

Profile Details

NPI number 1144419789
LBN Legal business name Bruton, Elizabeth R
Credentials Pediatric Nurse Practitioner (PNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 19th, 2007
Last updated Oct 6th, 2020 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1144419789 NPPES
Mississippi MEDICAID 00675504

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