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NPI Code Detail

MEDICARE: CAROLINE ETOK ELAD NP

MEDICARE: CAROLINE ETOK ELAD NP
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
1363L00000XNurse Practitioner79421KS
2363LA2200XAdult Health Nurse Practitioner5379421111KS

General Provider Information

NPI Number : 1700401163
Entity Type Code : Individual
Provider Name (Legal Business Name) : CAROLINE ETOK ELAD NP
Provider Business Mailing Address
First Line : 2051 E MARY ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-3617
Country : US
Telephone Number : 620-275-3777
Fax Number : 620-275-3074
Provider Business Practice Location Address
First Line : 2051 E MARY ST
Second Line :
City : GARDEN CITY
State : KS
Zip : 67846-3617
Country : US
Telephone Number : 620-275-3777
Fax Number : 620-275-3074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/11/2020
Last Update Date : 08/08/2023

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Directions to “ CAROLINE ETOK ELAD NP” Practice Location

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