Provider Demographics
NPI:1235733155
Name:ELITE HEALTHCARE, LLC
Entity Type:Organization
Organization Name:ELITE HEALTHCARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LUCY
Authorized Official - Middle Name:
Authorized Official - Last Name:BARNES
Authorized Official - Suffix:
Authorized Official - Credentials:FNP-C
Authorized Official - Phone:601-207-2017
Mailing Address - Street 1:4820 POPLAR SPRINGS DR.
Mailing Address - Street 2:STE. A, PMB 191
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39305-2678
Mailing Address - Country:US
Mailing Address - Phone:601-207-2017
Mailing Address - Fax:601-207-1227
Practice Address - Street 1:4555 35TH AVE
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39305-2544
Practice Address - Country:US
Practice Address - Phone:601-207-2017
Practice Address - Fax:601-207-1227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-23
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty