Healthcare Provider Details

I. General information

NPI: 1356747398
Provider Name (Legal Business Name): ELANA J NUTHALS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ELANA QUIRK

II. Dates (important events)

Enumeration Date: 11/18/2014
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 PASTEUR DR
STANFORD CA
94305-2200
US

IV. Provider business mailing address

300 PASTEUR DR
STANFORD CA
94305-2200
US

V. Phone/Fax

Practice location:
  • Phone: 650-723-4000
  • Fax:
Mailing address:
  • Phone: 650-723-4000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number95012446
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number95012446
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number6108-33
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: