Provider Demographics
NPI:1477993061
Name:MCELROY, NENITA JO (LAC)
Entity Type:Individual
Prefix:MRS
First Name:NENITA
Middle Name:JO
Last Name:MCELROY
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 ENCINITAS BLVD
Mailing Address - Street 2:SUITE 112
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-3742
Mailing Address - Country:US
Mailing Address - Phone:760-585-6959
Mailing Address - Fax:
Practice Address - Street 1:535 ENCINITAS BLVD
Practice Address - Street 2:SUITE 112
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-3742
Practice Address - Country:US
Practice Address - Phone:760-585-6959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-27
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAC15324171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist