Provider Demographics
NPI:1760457303
Name:ELAM, SYLVIA MARIE (FNP)
Entity Type:Individual
Prefix:MS
First Name:SYLVIA
Middle Name:MARIE
Last Name:ELAM
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4442 OAK RD
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-1236
Mailing Address - Country:US
Mailing Address - Phone:706-860-2826
Mailing Address - Fax:
Practice Address - Street 1:4442 OAK RD
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-1236
Practice Address - Country:US
Practice Address - Phone:706-830-6028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-17
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN085698363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCAPN 860OtherAPN LICENSE
GARN085698OtherAPN LICENSE
GARN085698OtherAPN LICENSE
SC7484417OtherDEA