Provider Demographics
NPI:1598281826
Name:ELPERS, POLLY (APRN)
Entity Type:Individual
Prefix:
First Name:POLLY
Middle Name:
Last Name:ELPERS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:POLLY
Other - Middle Name:
Other - Last Name:CATANESE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:311 E SPRUCE ST STE 3A
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5685
Mailing Address - Country:US
Mailing Address - Phone:620-275-3760
Mailing Address - Fax:620-275-3057
Practice Address - Street 1:311 E SPRUCE ST STE 3A
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5685
Practice Address - Country:US
Practice Address - Phone:620-275-3760
Practice Address - Fax:620-275-3057
Is Sole Proprietor?:No
Enumeration Date:2017-08-18
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS55-77816-101363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS77816OtherAPRN LICENSE