Provider Demographics
NPI:1558077883
Name:ELLIOTT, JASON MERRILL (FNP-C)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:MERRILL
Last Name:ELLIOTT
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:13960 STONE JUG RD
Mailing Address - Street 2:
Mailing Address - City:BATTLE CREEK
Mailing Address - State:MI
Mailing Address - Zip Code:49015-7617
Mailing Address - Country:US
Mailing Address - Phone:269-317-9913
Mailing Address - Fax:
Practice Address - Street 1:363 FREMONT ST STE 305
Practice Address - Street 2:
Practice Address - City:BATTLE CREEK
Practice Address - State:MI
Practice Address - Zip Code:49017-3391
Practice Address - Country:US
Practice Address - Phone:269-324-0799
Practice Address - Fax:269-324-8013
Is Sole Proprietor?:No
Enumeration Date:2023-01-30
Last Update Date:2023-04-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704292822363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily