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NPI Code Detail

MEDICARE: KATHRYN S ELLIOTT I RN,BSN

MEDICARE: KATHRYN S ELLIOTT I RN,BSN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WP2201XAmbulatory Care Registered NurseRN129698OH

General Provider Information

NPI Number : 1356591796
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHRYN S ELLIOTT I RN,BSN
Provider Business Mailing Address
First Line : 1460 TOD AVE NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2407
Country : US
Telephone Number : 330-392-0311
Fax Number : 330-392-2158
Provider Business Practice Location Address
First Line : 1460 TOD AVE NW
Second Line :
City : WARREN
State : OH
Zip : 44485-2407
Country : US
Telephone Number : 330-392-0311
Fax Number : 330-392-2158
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2008
Last Update Date : 09/23/2008

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