Provider Demographics
NPI:1508887092
Name:ELLIOTT, LAURIE LOUISE (RN, BSN, CFNP)
Entity Type:Individual
Prefix:MS
First Name:LAURIE
Middle Name:LOUISE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:RN, BSN, CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8033 RAY MEARS BLVD
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-5458
Mailing Address - Country:US
Mailing Address - Phone:865-545-4592
Mailing Address - Fax:
Practice Address - Street 1:8033 RAY MEARS BLVD
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5458
Practice Address - Country:US
Practice Address - Phone:865-545-4592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000006038363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner