Healthcare Provider Details

I. General information

NPI: 1790290245
Provider Name (Legal Business Name): LAUREL ASHLEY ELLIOTT APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 06/16/2025
Certification Date: 06/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25 HOSPITAL CENTER BLVD
HILTON HEAD ISLAND SC
29926-2738
US

IV. Provider business mailing address

13 SENTRY OAK LN
HILTON HEAD ISLAND SC
29926-2530
US

V. Phone/Fax

Practice location:
  • Phone: 843-681-6122
  • Fax:
Mailing address:
  • Phone: 843-816-1383
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number21506
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number212078
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: