Provider Demographics
NPI:1548678147
Name:ELLIOTT, BARBARA M S (LPN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:M S
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:691 COUNTY ROUTE 52
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13144-4420
Mailing Address - Country:US
Mailing Address - Phone:315-298-6424
Mailing Address - Fax:
Practice Address - Street 1:691 COUNTY ROUTE 52
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:NY
Practice Address - Zip Code:13144-4420
Practice Address - Country:US
Practice Address - Phone:315-298-6424
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-27
Last Update Date:2014-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY292598164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse