Individual
PAUL ELLIOTT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-C
Contact information
Practice address
645 S ROGERS ST, BLOOMINGTON, IN 47403-2353
(800) 344-8802
(812) 337-2259
Mailing address
654 S ROGERS ST, BLOOMINGTON, IN 47403
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
28256244A
IN
Other
Enumeration date
02/21/2025
Last updated
04/17/2025
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