Healthcare Provider Details

I. General information

NPI: 1194399766
Provider Name (Legal Business Name): LINDSEY NICOLE ELLIOTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/18/2021
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 SYLVANIA DR
DAYTON OH
45440-3237
US

IV. Provider business mailing address

PO BOX 381468
GERMANTOWN TN
38183-1468
US

V. Phone/Fax

Practice location:
  • Phone: 937-320-5050
  • Fax: 937-320-5060
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberAPRN.CNP.0028937
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: