Provider Demographics
NPI:1619935376
Name:POIRIER-ELLIOTT, ELAINE MARIE (PNP)
Entity Type:Individual
Prefix:MS
First Name:ELAINE
Middle Name:MARIE
Last Name:POIRIER-ELLIOTT
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 BROOKRIDGE DR NE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-3617
Mailing Address - Country:US
Mailing Address - Phone:404-874-4109
Mailing Address - Fax:
Practice Address - Street 1:NORTH DEKALB HEALTH CENTER
Practice Address - Street 2:3807 CLAIRMONT ROAD, NE
Practice Address - City:CHAMBLEE
Practice Address - State:GA
Practice Address - Zip Code:30341
Practice Address - Country:US
Practice Address - Phone:404-616-3047
Practice Address - Fax:404-616-3078
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2012-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN074932363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics