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General NPI Number Information
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NPI Number | 1164488953
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Entity Type | Individual
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Provider Name | BARBARA ELIAS PA-C
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Gender | Female
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Dates
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Enumeration Date | 04/21/2006
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 4545 E WILD ELK TRL
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-7941
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Country | US
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Telephone | 928-580-8886
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Fax |
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Provider Business Mailing Address
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Address Line | 4545 E WILD ELK TRL
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City | FLAGSTAFF
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State | AZ
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Zip | 86004-7941
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Country | US
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Telephone | 928-580-8886
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3213
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License Number State | AZ
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