Provider Demographics
NPI:1134466048
Name:ELLIOTT, PAMELA R (FNP-C)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:R
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2301 HOLMES ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2640
Mailing Address - Country:US
Mailing Address - Phone:816-404-3744
Mailing Address - Fax:816-858-2087
Practice Address - Street 1:3130 MERSINGTON AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64128-1755
Practice Address - Country:US
Practice Address - Phone:816-404-6700
Practice Address - Fax:816-404-6699
Is Sole Proprietor?:No
Enumeration Date:2013-01-11
Last Update Date:2020-11-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MO2013000996363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily