Provider Demographics
NPI:1225794878
Name:ELPHAGE, VERONICA
Entity Type:Individual
Prefix:MRS
First Name:VERONICA
Middle Name:
Last Name:ELPHAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22640 TIMBER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:DENHAM SPRINGS
Mailing Address - State:LA
Mailing Address - Zip Code:70726-8841
Mailing Address - Country:US
Mailing Address - Phone:225-993-9366
Mailing Address - Fax:
Practice Address - Street 1:22640 TIMBER RIDGE DR
Practice Address - Street 2:
Practice Address - City:DENHAM SPRINGS
Practice Address - State:LA
Practice Address - Zip Code:70726-8841
Practice Address - Country:US
Practice Address - Phone:225-993-9366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-09
Last Update Date:2021-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA008333273