Provider Demographics
NPI:1316570500
Name:ELSTON, MARIA FATIMA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:FATIMA
Last Name:ELSTON
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 1:252 UNION ST
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:OH
Mailing Address - Zip Code:45373-3671
Mailing Address - Country:US
Mailing Address - Phone:937-570-7168
Mailing Address - Fax:
Practice Address - Street 1:252 UNION ST
Practice Address - Street 2:
Practice Address - City:TROY
Practice Address - State:OH
Practice Address - Zip Code:45373-3671
Practice Address - Country:US
Practice Address - Phone:937-570-7168
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374T00000XNursing Service Related ProvidersReligious Nonmedical Nursing Personnel