Individual
ELLIOTT RACE
Active
Individual
ELLIOTT RACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN, BSN, RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
417080
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
023524
OH
Other
Enumeration date
06/06/2018
Last updated
09/05/2018
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