Individual
LATIFAH ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
960 HARVEST DR, #100, BLUE BELL, PA 19422
(215) 605-9336
Mailing address
118 S AMERICAN ST, WOODBURY, NJ 08096-2108
(215) 606-9336
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN307969
PA
Other
Enumeration date
03/16/2022
Last updated
03/16/2022
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