Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 2671 | SC |
NPI | 1851481576 |
---|---|
Provider Name | Mrs. Tamika D Elliott |
First Address | Greenville, SC 29615-4566 |
Second Address | Greer, SC 29650-1318 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/10/2006 |
Last Update Date | 28/07/2008 |