Individual
SANDRA K. ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
775 ENGINEERING DR, SPRINGFIELD, IL 62703-5909
(217) 522-4300
Mailing address
1025 S 6TH ST, SPRINGFIELD, IL 62703-2403
(217) 528-7541
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-003312
IL
Other
Enumeration date
09/27/2006
Last updated
02/03/2009
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