Provider Demographics
NPI:1477306835
Name:ELIAS, PAULA SHEARIN (AGNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:SHEARIN
Last Name:ELIAS
Suffix:
Gender:F
Credentials:AGNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1276
Mailing Address - Street 2:
Mailing Address - City:ROANOKE RAPIDS
Mailing Address - State:NC
Mailing Address - Zip Code:27870-7076
Mailing Address - Country:US
Mailing Address - Phone:252-326-3456
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 1276
Practice Address - Street 2:
Practice Address - City:ROANOKE RAPIDS
Practice Address - State:NC
Practice Address - Zip Code:27870-7076
Practice Address - Country:US
Practice Address - Phone:252-326-3456
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCAG04240001363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology