Healthcare Provider Details

I. General information

NPI: 1194261339
Provider Name (Legal Business Name): JOANNE ELFFERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/11/2017
Last Update Date: 01/11/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6584 MEADOW FARM DR
HUDSON OH
44236-3233
US

IV. Provider business mailing address

6584 MEADOW FARM DR
HUDSON OH
44236-3233
US

V. Phone/Fax

Practice location:
  • Phone: 330-671-3088
  • Fax:
Mailing address:
  • Phone: 330-671-3088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number194368
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: