Individual
JOHN C ELKINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
4305 DENNY AVE, PASCAGOULA, MS 39581-5509
(228) 762-2044
Mailing address
4305 DENNY AVE, PASCAGOULA, MS 39581-5509
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
1-110201
AL
163W00000X
Registered Nurse
R887805
MS
363L00000X
Nurse Practitioner
1-110201
AL
363LF0000X
Family Nurse Practitioner
Primary
R887805
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1003122821
TRICARE SOUTH
AL
05
—
122801
—
AL
05
—
122803
—
AL
01
—
511-10258
BCBS
AL
01
—
511-10260
BCBS
AL
01
—
Z12065
VIVA HEALTH
AL
Enumeration date
08/31/2010
Last updated
08/30/2011
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