Provider Demographics
NPI:1588823603
Name:ARMSTRONG, ELAINE ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:ANN
Last Name:ARMSTRONG
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 1:13622 FALCON RIDGE CV
Mailing Address - Street 2:
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46845-8707
Mailing Address - Country:US
Mailing Address - Phone:260-637-9838
Mailing Address - Fax:
Practice Address - Street 1:13622 FALCON RIDGE CV
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46845-8707
Practice Address - Country:US
Practice Address - Phone:260-637-9838
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28120282A163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200846720Medicaid
IN200846720OtherFIRST STEPS