Individual
NICOLE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 779-1282
(541) 608-2888
Mailing address
1003 E MAIN ST STE 104, MEDFORD, OR 97504-7140
(541) 779-1282
(541) 608-2888
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
Primary
201141590RN
OR
Other
Enumeration date
05/17/2016
Last updated
05/17/2016
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