Provider Demographics
NPI:1710244322
Name:ELLIOTT, AIMEE LYNNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:AIMEE
Middle Name:LYNNE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:131 GLENERIE BLVD
Mailing Address - Street 2:
Mailing Address - City:SAUGERTIES
Mailing Address - State:NY
Mailing Address - Zip Code:12477-4905
Mailing Address - Country:US
Mailing Address - Phone:845-802-4950
Mailing Address - Fax:
Practice Address - Street 1:131 GLENERIE BLVD
Practice Address - Street 2:
Practice Address - City:SAUGERTIES
Practice Address - State:NY
Practice Address - Zip Code:12477-4905
Practice Address - Country:US
Practice Address - Phone:845-802-4950
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308681-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse