Individual
MRS. SANDRA E ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM, MSN
Contact information
Practice address
540 S COLLEGE AVE, SUITE 130, NEWARK, DE 19713-1302
(302) 831-3195
(302) 831-3193
Mailing address
540 S COLLEGE AVE, SUITE 130, NEWARK, DE 19713-1302
(302) 831-3195
(302) 831-3193
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
L10019057
DE
367A00000X
Advanced Practice Midwife
Primary
LK0000110
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0001030139
—
DE
01
—
028791YNMM
MEDICARE PTAN
DE
01
—
2269350000
AMERI HEALTH
DE
01
—
7423
MID-ATLANTIC
DE
Enumeration date
06/16/2005
Last updated
04/06/2015
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