| Element | Element Name | Character Length | Required | Notes |
|---|---|---|---|---|
| N101 | Entity Identifier Code | 2-3 | ✅ | |
| N102 | Name | 1-60 | ✅ | |
| N103 | Identification Code Qualifier | 1-2 | ✅ | |
| N104 | Identification Code | 2-80 | ✅ | |
| N301 | Address Information 1 | 1-55 | ✅ | |
| N302 | Address Information 2 | 1-55 | ✅ | |
| N401 | City Name | 1-55 | ✅ | |
| N402 | State or Province Code | 2-2 | ✅ | |
| N403 | Postal Code | 3-15 | ✅ | |
| N404 | Country Code | 2-3 |