Healthcare Provider Details

I. General information

NPI: 1861784373
Provider Name (Legal Business Name): ANN R. ELLIOTT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2011
Last Update Date: 05/03/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

151 W. 7TH AVE. LANE COUNTY PUBLIC HEALTH
EUGENE OR
97401-2676
US

IV. Provider business mailing address

151 W. 7TH AVE. LANE COUNTY PUBLIC HEALTH
EUGENE OR
97401-2676
US

V. Phone/Fax

Practice location:
  • Phone: 541-682-3914
  • Fax: 541-682-3925
Mailing address:
  • Phone: 541-682-3914
  • Fax: 541-682-3925

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number084062671RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License Number084062671RN
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: