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General NPI Number Information
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NPI Number | 1275457020
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Entity Type | Individual
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Provider Name | AMBER NICOLE ELLIOTT
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Gender | Female
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Dates
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Enumeration Date | 08/05/2026
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Last Update Date | 08/05/2026
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Provider Practice Location Address
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Address Line | 6465 STAUNTON TPKE
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City | DAVISVILLE
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State | WV
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Zip | 26142-8220
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Country | US
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Telephone | 304-420-9557
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Fax |
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Provider Business Mailing Address
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Address Line | 501 22ND ST
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City | DUNBAR
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State | WV
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Zip | 25064-1711
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Country | US
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Telephone | 304-766-0011
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Fax | 304-766-0022
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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 | 163WS0200X
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Taxonomy Name | School Registered Nurse
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License Number | 102124
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License Number State | WV
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