Individual
CONNIE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 W 22ND ST STE 309, ANDERSON, IN 46016-4389
(765) 646-8569
Mailing address
141 W 22ND ST STE 309, ANDERSON, IN 46016-4389
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71006017A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000992951
ANTHEM
IN
05
—
201347420
—
IN
Enumeration date
02/16/2016
Last updated
06/20/2022
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