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General NPI Number Information
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NPI Number | 1740202282
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Entity Type | Individual
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Provider Name | TRACI L. ELLIFF A.P.R.N.
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Gender | Female
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Dates
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Enumeration Date | 07/24/2006
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Last Update Date | 08/26/2016
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Provider Practice Location Address
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Address Line | 12600 CANTRELL RD #200
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City | LITTLE ROCK
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State | AR
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Zip | 72223-1604
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Country | US
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Telephone | 501-581-1212
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Fax | 501-712-1400
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Provider Business Mailing Address
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Address Line | 29 WEATHERWOOD DR
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City | GREENBRIER
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State | AR
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Zip | 72058-8816
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Country | US
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Telephone | 479-414-8089
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | M01019
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License Number State | AR
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A03361 ANP
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License Number State | AR
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