Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP2300X | Nurse Practitioner - Primary Care | RN286863 | OH |
NPI | 1073581674 |
---|---|
Provider Name | Katherine Colleen Elliot |
First Address | Westerville, OH 43082-8387 |
Second Address | Westerville, OH 43082-8387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/03/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q61773 | (02) | OH |