Individual
GAYLE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
308 GRIFFITH ST, PINEVILLE, LA 71360-5270
(318) 528-5000
(318) 448-8013
Mailing address
2900 SAINT MICHAEL DR STE 401, TEXARKANA, TX 75503-5211
(903) 614-5367
(903) 614-5343
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP10054
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2483561
—
LA
Enumeration date
07/06/2018
Last updated
03/20/2019
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