Provider Demographics
NPI:1033970058
Name:BELTON, ELVA VIRGINIA (LPN)
Entity Type:Individual
Prefix:
First Name:ELVA
Middle Name:VIRGINIA
Last Name:BELTON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6209 SATINWOOD DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MD
Mailing Address - Zip Code:21044-3606
Mailing Address - Country:US
Mailing Address - Phone:410-274-8359
Mailing Address - Fax:
Practice Address - Street 1:6209 SATINWOOD DR
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MD
Practice Address - Zip Code:21044-3606
Practice Address - Country:US
Practice Address - Phone:410-274-8359
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLP35996164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse