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General NPI Number Information
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NPI Number | 1992004824
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Entity Type | Individual
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Provider Name | AIMEE ELLIOTT NP
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Gender | Female
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Dates
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Enumeration Date | 03/17/2011
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Last Update Date | 02/19/2020
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Provider Practice Location Address
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Address Line | 630 ONEEGA LN SUITE A
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City | ERWIN
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State | TN
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Zip | 37650-2197
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Country | US
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Telephone | 423-735-5700
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Fax | 423-735-5723
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Provider Business Mailing Address
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Address Line | 300 E MAIN ST
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City | JOHNSON CITY
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State | TN
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Zip | 37601-5705
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Country | US
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Telephone | 423-979-0000
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Fax | 423-979-6333
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | 15675
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 5012449
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License Number State | NC
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