Provider Demographics
NPI:1619426400
Name:ELROD, KERITH CHRISTINA (DNP, CPNP-PC)
Entity Type:Individual
Prefix:
First Name:KERITH
Middle Name:CHRISTINA
Last Name:ELROD
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2420 S CROATAN HWY STE D
Mailing Address - Street 2:
Mailing Address - City:NAGS HEAD
Mailing Address - State:NC
Mailing Address - Zip Code:27959-9014
Mailing Address - Country:US
Mailing Address - Phone:252-715-1129
Mailing Address - Fax:252-719-1128
Practice Address - Street 1:2420 S CROATAN HWY STE D
Practice Address - Street 2:
Practice Address - City:NAGS HEAD
Practice Address - State:NC
Practice Address - Zip Code:27959-9014
Practice Address - Country:US
Practice Address - Phone:252-715-1129
Practice Address - Fax:252-719-1128
Is Sole Proprietor?:No
Enumeration Date:2016-09-22
Last Update Date:2024-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5016906363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics