Elliott, Alicia A

Elliott, Alicia A is an individual health care provider with primary practice located at 1720 Beacon St , Fort Wayne IN 46805-4749. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Elliott, Alicia A can be contacted via phone (260) 373-8000.

Contact Information

Primary practice address
1720 Beacon St Fort Wayne IN 46805-4749
Phone: (260) 373-8000
Fax: (260) 373-8034
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 364SP0808X 71003708A Indiana

Profile Details

NPI number 1699071100
LBN Legal business name Elliott, Alicia A
Credentials Clinical Nurse Specialist (CNS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 31st, 2011
Last updated May 10th, 2021 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1699071100 NPPES
Indiana MEDICAID 201033980
Indiana Other 000000730490

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