Provider Demographics
NPI:1326373705
Name:ELKINS, LAURIE JEWEL (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:LAURIE
Middle Name:JEWEL
Last Name:ELKINS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 WASHINGTON AVENUE
Mailing Address - Street 2:
Mailing Address - City:NITRO
Mailing Address - State:WV
Mailing Address - Zip Code:25143
Mailing Address - Country:US
Mailing Address - Phone:304-755-0415
Mailing Address - Fax:
Practice Address - Street 1:905 WASHINGTON AVENUE
Practice Address - Street 2:
Practice Address - City:NITRO
Practice Address - State:WV
Practice Address - Zip Code:25143
Practice Address - Country:US
Practice Address - Phone:304-755-0415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2009-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV52317367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered