NPI | 1518394196 |
---|---|
Former Name | J. CAROL ELLIOTT |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: FL CNS9457676) |
Additional Taxonomies | 163WP0809X Registered Nurse, Psych/Mental Health, Adult (Licence: MA RN241276) |
363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 6927) | |
Enumeration Date | 2013-09-27 |
Last Update Date | 2023-05-17 |