Individual
ELYSIA SMALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1501 S YALE ST, BUILDING 2 SUITE 150, FLAGSTAFF, AZ 86001-7304
(928) 527-4325
(928) 527-4327
Mailing address
PO BOX 35380, LAS VEGAS, NV 89133-5380
(702) 954-7761
(928) 527-4327
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
6563
AZ
Other
Enumeration date
10/17/2016
Last updated
07/25/2024
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