Individual
MICHELE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2345 DEEP WOOD DR, LOGANVILLE, GA 30052-7447
(770) 680-0807
Mailing address
2345 DEEP WOOD DR, LOGANVILLE, GA 30052-7447
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN080320
GA
Other
Enumeration date
11/22/2021
Last updated
11/22/2021
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