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Individual
JENNIFER L ELLIOTT
Active
Individual
JENNIFER L ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
RN.373278
OH
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
RN.373278
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1790735462
NPI
OH
05
—
2263910
—
OH
01
—
367771
MEDICARE
OH
Enumeration date
09/18/2018
Last updated
09/18/2018
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