Provider Demographics
NPI:1659545846
Name:WAHL, ELAINA L (RN,BSN)
Entity Type:Individual
Prefix:MRS
First Name:ELAINA
Middle Name:L
Last Name:WAHL
Suffix:
Gender:F
Credentials:RN,BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 CHELSEA CV
Mailing Address - Street 2:
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-0811
Mailing Address - Country:US
Mailing Address - Phone:740-844-0037
Mailing Address - Fax:
Practice Address - Street 1:153 CHELSEA CV
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-0811
Practice Address - Country:US
Practice Address - Phone:740-844-0037
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-04-17
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN199572163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse