Provider Demographics
NPI:1073803680
Name:ELMORE, PATRICIA PHILLIPS (CRNP)
Entity Type:Individual
Prefix:MS
First Name:PATRICIA
Middle Name:PHILLIPS
Last Name:ELMORE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3007 MEMORIAL PKWY SW STE C
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-5394
Mailing Address - Country:US
Mailing Address - Phone:256-382-3344
Mailing Address - Fax:256-382-3355
Practice Address - Street 1:3007 MEMORIAL PKWY SW
Practice Address - Street 2:STE C
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-5393
Practice Address - Country:US
Practice Address - Phone:256-382-3344
Practice Address - Fax:256-382-3355
Is Sole Proprietor?:No
Enumeration Date:2011-04-15
Last Update Date:2011-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-100309363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health