Provider Demographics
NPI:1053825430
Name:ELLIFF, ERIN NICOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ERIN
Middle Name:NICOLE
Last Name:ELLIFF
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:195 SOUTHWIND RD
Mailing Address - Street 2:
Mailing Address - City:CENTER POINT
Mailing Address - State:TX
Mailing Address - Zip Code:78010-5563
Mailing Address - Country:US
Mailing Address - Phone:361-935-9708
Mailing Address - Fax:
Practice Address - Street 1:1216 JUNCTION HWY
Practice Address - Street 2:
Practice Address - City:KERRVILLE
Practice Address - State:TX
Practice Address - Zip Code:78028-4906
Practice Address - Country:US
Practice Address - Phone:830-896-5511
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-21
Last Update Date:2017-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX61279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist