Provider Demographics
NPI:1861971681
Name:ELLIOTT, SYMONE (LVN)
Entity type:Individual
Prefix:
First Name:SYMONE
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LVN
Other - Prefix:
Other - First Name:SYMONE
Other - Middle Name:
Other - Last Name:HARVEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:126 VILLE SERENE
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78253-5582
Mailing Address - Country:US
Mailing Address - Phone:210-243-8591
Mailing Address - Fax:
Practice Address - Street 1:5726 W HAUSMAN RD
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78249-1650
Practice Address - Country:US
Practice Address - Phone:210-349-7030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-13
Last Update Date:2018-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX327179164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse