Provider Demographics
NPI:1053850867
Name:MCELHANEY, KATELYN (PPCNP-BC)
Entity Type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:MCELHANEY
Suffix:
Gender:F
Credentials:PPCNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:LISBON
Mailing Address - State:OH
Mailing Address - Zip Code:44432-1014
Mailing Address - Country:US
Mailing Address - Phone:330-424-9866
Mailing Address - Fax:304-247-6893
Practice Address - Street 1:400 N MARKET ST
Practice Address - Street 2:
Practice Address - City:LISBON
Practice Address - State:OH
Practice Address - Zip Code:44432-1014
Practice Address - Country:US
Practice Address - Phone:330-424-9866
Practice Address - Fax:330-424-7689
Is Sole Proprietor?:No
Enumeration Date:2017-02-14
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV81237363LP0200X
OH024035363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics