Healthcare Provider Details

I. General information

NPI: 1174611693
Provider Name (Legal Business Name): ELALEE COSS CNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

910 MONROE ST
MARTINS FERRY OH
43935-2009
US

IV. Provider business mailing address

910 MONROE ST
MARTINS FERRY OH
43935-2009
US

V. Phone/Fax

Practice location:
  • Phone: 740-633-9424
  • Fax:
Mailing address:
  • Phone: 740-633-9424
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code376K00000X
TaxonomyNurse's Aide
License Number
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: