Individual
ALICIA A ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNS
Contact information
Practice address
1910 SAINT JOE CENTER RD STE 23, FORT WAYNE, IN 46825-5000
(260) 414-4025
(260) 484-5664
Mailing address
1910 ST JOE CTR RD #23, FORT WAYNE, IN 46825-1701
Taxonomy
Speciality
Code
Description
License number
State
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
Primary
71003708A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000730490
ANTHEM
IN
05
—
201033980
—
IN
Enumeration date
01/31/2011
Last updated
03/20/2025
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