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General NPI Number Information
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NPI Number | 1851067185
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Entity Type | Individual
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Provider Name | SARA CATHERINE ELLIOTT FNP-C
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Gender | Female
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Dates
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Enumeration Date | 08/17/2021
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Last Update Date | 11/08/2021
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Provider Practice Location Address
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Address Line | 1500 LINE AVE
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City | SHREVEPORT
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State | LA
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Zip | 71101-4639
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Country | US
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Telephone | 318-629-5555
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Fax |
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Provider Business Mailing Address
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Address Line | 1500 LINE AVE STE 200
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City | SHREVEPORT
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State | LA
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Zip | 71101-4643
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Country | US
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Telephone | 318-629-5555
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 221804
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License Number State | LA
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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 | 221804
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License Number State | LA
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