Provider Demographics
NPI:1861210387
Name:ELAM, ROCKI LYNN (NP, CNS, RN)
Entity type:Individual
Prefix:MS
First Name:ROCKI
Middle Name:LYNN
Last Name:ELAM
Suffix:
Gender:F
Credentials:NP, CNS, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10503 WILLIAMSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER
Mailing Address - State:VA
Mailing Address - Zip Code:23069-1835
Mailing Address - Country:US
Mailing Address - Phone:804-690-9033
Mailing Address - Fax:
Practice Address - Street 1:3500 FETCHET AVE
Practice Address - Street 2:
Practice Address - City:JB ANDREWS
Practice Address - State:MD
Practice Address - Zip Code:20762-5157
Practice Address - Country:US
Practice Address - Phone:804-690-9033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-02
Last Update Date:2024-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001205025163W00000X
VA0024181833364SA2200X, 364SG0600X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse
No364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health
No364SG0600XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistGerontology