MEDICARE: NORINE ELLIOTT APRN

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	020495-23-08	NH

General Provider Information

NPI Number	:	1740464015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NORINE ELLIOTT APRN

Provider Business Mailing Address
First Line	:	5 NORTH RD
Second Line	:
City	:	BERLIN
State	:	NH
Zip	:	03570-3726
Country	:	US
Telephone Number	:	603-752-1876
Fax Number	:

Provider Business Practice Location Address
First Line	:	5 NORTH RD
Second Line	:
City	:	BERLIN
State	:	NH
Zip	:	03570-3726
Country	:	US
Telephone Number	:	603-752-1876
Fax Number	:

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

Provider Enumeration Date	:	12/22/2007
Last Update Date	:	09/17/2009

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