Healthcare Provider Details

I. General information

NPI: 1134509284
Provider Name (Legal Business Name): LAUREN A ELSAS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/04/2015
Last Update Date: 06/07/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 NORTH E STREET STE 300
PENSACOLA FL
32501-6336
US

IV. Provider business mailing address

P.O. BOX 622047
ORLANDO FL
32862-2047
US

V. Phone/Fax

Practice location:
  • Phone: 850-432-6821
  • Fax: 850-438-6821
Mailing address:
  • Phone: 850-432-6851
  • Fax: 850-438-6821

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberARNP 9292527
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: