Doctor Name: | MS. MARY JO ELKINS |
NPI Number: | 1053546226 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNP-C |
License Number: | 71002770A |
Business Practice Address: | 809 Laporte Ave Valparaiso, IN - 463835801 |
Business Phone Number: | 2194634950 |
Business Fax Number: | 2195483172 |
Mailing Address: | 809 Laporte Ave, VALPARAISO |
State: | IN |
Postal Code: | 463835801 |
Phone Number: | 2194634950 |
Fax Number: | 2195483172 |
NPI Enumeration Date: | 05/18/2009 |
NPI Last Update Date: | 03/02/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 71002770A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |