MEDICARE: HEATHER MARIE ELKIN 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	31816	SC

General Provider Information

NPI Number	:	1164366597
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATHER MARIE ELKIN FNP-C

Provider Business Mailing Address
First Line	:	5 CRITERION DR
Second Line	:
City	:	SIMPSONVILLE
State	:	SC
Zip	:	29681-6368
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	877 W FARIS RD
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29605-4289
Country	:	US
Telephone Number	:	864-455-8889
Fax Number	:

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

Provider Enumeration Date	:	04/16/2026
Last Update Date	:	04/16/2026

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