Provider Demographics
NPI:1518481589
Name:ELMS, AMY (APRN)
Entity type:Individual
Prefix:MRS
First Name:AMY
Middle Name:
Last Name:ELMS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 GREENE 721 RD STE 4
Mailing Address - Street 2:
Mailing Address - City:PARAGOULD
Mailing Address - State:AR
Mailing Address - Zip Code:72450-8995
Mailing Address - Country:US
Mailing Address - Phone:870-472-8403
Mailing Address - Fax:870-472-8422
Practice Address - Street 1:160 GREENE 721 RD STE 4
Practice Address - Street 2:
Practice Address - City:PARAGOULD
Practice Address - State:AR
Practice Address - Zip Code:72450-8995
Practice Address - Country:US
Practice Address - Phone:870-472-8403
Practice Address - Fax:870-472-8422
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2025-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA005289363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR222827758Medicaid