Individual
MS. KRISTA NICOLE ELLIOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
55 LAKE AVE N, WORCESTER, MA 01655-0002
(508) 856-5599
Mailing address
PO BOX 415348, BOSTON, MA 02241-5348
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN233010
MA
363LA2100X
Acute Care Nurse Practitioner
Primary
RN233010
MA
363LA2200X
Adult Health Nurse Practitioner
233010
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110091727A
—
MA
Enumeration date
01/10/2007
Last updated
11/01/2022
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