Healthcare Provider Details

I. General information

NPI: 1861114787
Provider Name (Legal Business Name): MEGHAN LYNN ELLIOTT DNP, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 09/16/2022
Certification Date: 09/16/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

124 SLEEPY HOLLOW DR. SUITE 203
MIDDLETOWN DE
19709
US

IV. Provider business mailing address

124 SLEEPY HOLLOW DR STE 203
MIDDLETOWN DE
19709-5838
US

V. Phone/Fax

Practice location:
  • Phone: 302-449-3037
  • Fax: 302-449-3040
Mailing address:
  • Phone: 302-449-3037
  • Fax: 302-449-3040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberLG-0011918
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: