Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LG0600X | Nurse Practitioner - Gerontology | AG0919006 | OH |
Y | 363LG0600X | Nurse Practitioner - Gerontology | APRNCNP025919 | OH |
NPI | 1053943134 |
---|---|
Provider Name | Chunyan Mcelroy |
First Address | Troy, MI 48084-4135 |
Second Address | Chardon, OH 44024-9379 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/02/2020 |
Last Update Date | 13/10/2021 |