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Individual
ELYSE LYN THORNE
Active
Individual
ELYSE LYN THORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28206959A
IN
363L00000X
Nurse Practitioner
Primary
71010471A
IN
363LF0000X
Family Nurse Practitioner
71010471A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300043513
—
IN
01
—
364430289
MEDICARE PTAN
IN
Enumeration date
02/28/2020
Last updated
02/06/2024
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