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General NPI Number Information
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NPI Number | 1336612571
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Entity Type | Individual
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Provider Name | SARAH ELIZABETH ELLIOTT RN
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Gender | Female
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Dates
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Enumeration Date | 01/10/2019
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Last Update Date | 01/10/2019
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Provider Practice Location Address
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Address Line | 500 AZ 89
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City | PRESCOTT
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State | AZ
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Zip | 86301
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Country | US
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Telephone | 928-445-4860
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Fax |
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Provider Business Mailing Address
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Address Line | 11265 E KATHY LN
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City | DEWEY
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State | AZ
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Zip | 86327-7093
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Country | US
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Telephone | 928-713-5983
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | RN087222
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License Number State | AZ
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