Individual
DR. SUSAN JANE ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, FNP-C
Contact information
Practice address
1201 S GRAND BLVD, SAINT LOUIS, MO 63104-1016
(314) 977-8462
(314) 977-3370
Mailing address
1008 S SPRING AVE FL 2, SAINT LOUIS, MO 63110-2520
(314) 977-8462
(314) 977-3370
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
2018026391
MO
363LG0600X
Gerontology Nurse Practitioner
Primary
F07181228
MO
Other
Enumeration date
10/31/2018
Last updated
03/15/2021
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