MEDICARE: PAMELA R ELLIOTT FNP-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	2013000996	MO

General Provider Information

NPI Number	:	1134466048
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA R ELLIOTT FNP-C

Provider Business Mailing Address
First Line	:	2301 HOLMES ST
Second Line	:
City	:	KANSAS
State	:	MO
Zip	:	64108-2640
Country	:	US
Telephone Number	:	816-404-3744
Fax Number	:	816-858-2087

Provider Business Practice Location Address
First Line	:	3130 MERSINGTON AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64128-1755
Country	:	US
Telephone Number	:	816-404-6700
Fax Number	:	816-404-6699

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/11/2013
Last Update Date	:	11/16/2020

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