Individual
CHRISTY RENEE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
402 CUMBERLAND AVE, WILLIAMSBURG, KY 40769-1238
(606) 549-2656
Mailing address
107 S MAIN ST, JELLICO, TN 37762-2154
(423) 784-8492
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
1099206
KY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
34175
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4004534
KY LICENSE
KY
05
—
7100905220
—
KY
Enumeration date
01/12/2023
Last updated
07/26/2023
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