Individual
MRS. ANITA ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
101 MAYO ST, SUITE B, AMERICUS, GA 31709-3695
(229) 928-8355
Mailing address
101 MAYO ST, SUITE B, AMERICUS, GA 31709-3695
(229) 928-8355
(229) 928-8358
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
198479
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003148065A
—
GA
Enumeration date
05/14/2014
Last updated
01/26/2015
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