Provider Demographics
NPI:1346720158
Name:ELMORE, AMY CHRISTINE (RN)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:CHRISTINE
Last Name:ELMORE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:RANSOM CANYON
Mailing Address - State:TX
Mailing Address - Zip Code:79366-2315
Mailing Address - Country:US
Mailing Address - Phone:806-549-3954
Mailing Address - Fax:
Practice Address - Street 1:5225 S LOOP 289 STE 210
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-1319
Practice Address - Country:US
Practice Address - Phone:806-780-4180
Practice Address - Fax:806-744-7458
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2018-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX795947163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health