Individual
LYDIA ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-CNM
Contact information
Practice address
2 MEDICAL PARK RD STE 107, COLUMBIA, SC 29203-6839
(803) 434-4480
(803) 434-3340
Mailing address
300 E MCBEE AVE STE 300, GREENVILLE, SC 29601-2899
(864) 522-8611
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
19531
SC
367A00000X
Advanced Practice Midwife
RN294300
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300034164A
—
GA
01
—
GRP3569
MEDICARE OPT-OUT
GA
Enumeration date
06/30/2015
Last updated
05/20/2025
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