Provider Demographics
NPI:1760729297
Name:ELLIOTT, STEPHANIE CHRISTINE (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:STEPHANIE
Middle Name:CHRISTINE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 DAUGHERTY DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MONROEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:15146-2749
Mailing Address - Country:US
Mailing Address - Phone:412-856-2090
Mailing Address - Fax:412-856-6907
Practice Address - Street 1:125 DAUGHERTY DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MONROEVILLE
Practice Address - State:PA
Practice Address - Zip Code:15146-2749
Practice Address - Country:US
Practice Address - Phone:412-856-2090
Practice Address - Fax:412-856-6907
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2016-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP012654363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner