Doctor Name: | STEPHANIE ELLIOTT |
NPI Number: | 1558576074 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | L.A.T. |
License Number: | AT1971 |
Business Practice Address: | 1000 Milam St. Hemphill, TX - 75948 |
Business Phone Number: | 4097873371 |
Business Fax Number: | 4097871259 |
Mailing Address: | Hc 53 Box 5070, 613 Ranger Smith Ct. HEMPHILL |
State: | TX |
Postal Code: | 759489522 |
Phone Number: | 4095792591 |
Fax Number: | |
NPI Enumeration Date: | 05/10/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 390200000X |
License Number: | AT1971 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | TX |
Taxonomy Type: | Student, Health Care |
Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |