Provider Demographics
NPI:1174004816
Name:BOLLINGER, ELENA NICOLE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:NICOLE
Last Name:BOLLINGER
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 1:17212 N SCOTTSDALE RD APT 2400
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-9623
Mailing Address - Country:US
Mailing Address - Phone:724-504-2684
Mailing Address - Fax:
Practice Address - Street 1:6501 E GREENWAY PKWY
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85254-2025
Practice Address - Country:US
Practice Address - Phone:480-368-7893
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS0235021835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist