Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mrs. Elisabeth Ann Proenza, FNP-C

Individual provider Family Nurse Practitioner · NPI 1619591120

Mrs. Elisabeth Ann Proenza, FNP-C is a Nurse Practitioner in Vidalia, Georgia. Qualified in 2020, 6 years ago. Practices with Misty D. Poole, MD LLC, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Georgia.

Years since qualifying
6
Licensed in
GA
In the registry since
2020
What do these letters mean?
FNP-C — Family Nurse Practitioner, Certified
A family nurse practitioner certified by the AANP.

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Practice location Address checks out

210 Mose Coleman Dr
Vidalia, GA 30474-8677
Phone: (912) 308-6484
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence RN156767 (GA)

Record details

NPI number1619591120
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP-C
Sole proprietorNo
NPI enumeratedMay 31, 2020
Last updated in NPPESDecember 8, 2021
Certification dateDecember 8, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Misty D. Poole, Md Llc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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