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NPI Code Detail

MEDICARE: BELINDA JEANETTE ELAM

MEDICARE:   BELINDA JEANETTE ELAM
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
1164W00000XLicensed Practical Nurse135424OH

General Provider Information

NPI Number : 1467704585
Entity Type Code : Individual
Provider Name (Legal Business Name) : BELINDA JEANETTE ELAM
Provider Business Mailing Address
First Line : 21112 GARDENVIEW DR
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-2428
Country : US
Telephone Number : 330-285-1431
Fax Number :
Provider Business Practice Location Address
First Line : 21112 GARDENVIEW DR
Second Line :
City : MAPLE HEIGHTS
State : OH
Zip : 44137-2428
Country : US
Telephone Number : 330-285-1431
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2012
Last Update Date : 10/14/2012

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Directions to “ BELINDA JEANETTE ELAM ” Practice Location

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