Individual
LAURA K ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2508 25TH ST, ROCK ISLAND, IL 61201-5419
(309) 732-0958
(309) 732-0963
Mailing address
2508 25TH ST, ROCK ISLAND, IL 61201-5419
(309) 732-0958
(309) 732-0963
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
A095968
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
833610
MEDICARE GROUP #
—
Enumeration date
11/14/2008
Last updated
10/01/2018
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