Individual
LISA ANN ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
161 BOOKER LN, CANTONMENT, FL 32533-1528
(850) 760-3555
Mailing address
161 BOOKER LN, CANTONMENT, FL 32533-1528
(850) 760-3555
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
323560
FL
Other
Enumeration date
05/09/2016
Last updated
05/09/2016
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