Healthcare Provider Details

I. General information

NPI: 1790079523
Provider Name (Legal Business Name): ELENA E. ARUSHANYAN APRN, NP-C, RN-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

201 INDEPENDENCE BLDG 1100
COLUMBUS MS
39710-5300
US

IV. Provider business mailing address

RAF LAKENHEATH 48 MDG/SGHC UNIT 5115
APO AE
09461-5115
US

V. Phone/Fax

Practice location:
  • Phone: 662-434-2273
  • Fax:
Mailing address:
  • Phone: 011441638528124
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number810425
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number810425
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR031872
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: