Individual
JENNIFER L ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3920 S ROME ST, GILBERT, AZ 85297-7366
(480) 597-4778
Mailing address
1900 W CHANDLER BLVD STE 15-331, CHANDLER, AZ 85224-6216
(509) 885-6395
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4804
AZ
207L00000X
Anesthesiology Physician
DO1413
NV
207L00000X
Anesthesiology Physician
OP60155521
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1427263485
—
WA
01
—
P01314799
RR MEDICARE
WA
Enumeration date
05/13/2007
Last updated
11/04/2020
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