Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LW0102X | Nurse Practitioner - Women's Health | 1-100309 | AL |
NPI | 1073803680 |
---|---|
Provider Name | Ms. Patricia Phillips Elmore |
First Address | Huntsville, AL 35801-5394 |
Second Address | Huntsville, AL 35801-5393 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2011 |
Last Update Date | 15/04/2011 |