Individual
KARREN LYNN ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
9900 BREN RD E, MINNETONKA, MN 55343-9664
(229) 400-4707
Mailing address
2731 JOEL POOLE RD, DONALSONVILLE, GA 39845-5968
(229) 400-4707
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN133023
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003159293A
—
GA
01
—
RN133023
MEDICAL LICENSE
GA
Enumeration date
03/04/2015
Last updated
06/30/2020
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