Provider Demographics
NPI:1124561725
Name:ELKINS, SUSAN ELAINE (RN)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:ELAINE
Last Name:ELKINS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 FALL ST
Mailing Address - Street 2:
Mailing Address - City:SENECA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:13148-1521
Mailing Address - Country:US
Mailing Address - Phone:315-224-3418
Mailing Address - Fax:
Practice Address - Street 1:750 MAIDEN LN
Practice Address - Street 2:
Practice Address - City:GREECE
Practice Address - State:NY
Practice Address - Zip Code:14615-1230
Practice Address - Country:US
Practice Address - Phone:585-966-8800
Practice Address - Fax:585-581-8131
Is Sole Proprietor?:No
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY502613163W00000X, 163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WS0200XNursing Service ProvidersRegistered NurseSchool