| Doctor Name: | HEATHER ELMORE |
| NPI Number: | 1265832323 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | ARNP |
| License Number: | C114749 |
| Business Practice Address: | 5409 Avenue O Fort Madison, IA - 526279601 |
| Business Phone Number: | 3193762134 |
| Business Fax Number: | 3193762188 |
| Mailing Address: | 5409 Avenue O, FORT MADISON |
| State: | IA |
| Postal Code: | 526279601 |
| Phone Number: | 3193762134 |
| Fax Number: | 3193762188 |
| NPI Enumeration Date: | 08/26/2014 |
| NPI Last Update Date: | 08/26/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0200X |
| License Number: | C114749 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | IA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |