Provider Demographics
NPI:1821276239
Name:ELLIOTT, SHEILA (HIS/ACA)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:HIS/ACA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:194 MADISON SQUARE DR
Mailing Address - Street 2:
Mailing Address - City:MADISONVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:42431-2794
Mailing Address - Country:US
Mailing Address - Phone:270-821-9451
Mailing Address - Fax:270-821-0242
Practice Address - Street 1:194 MADISON SQUARE DR
Practice Address - Street 2:
Practice Address - City:MADISONVILLE
Practice Address - State:KY
Practice Address - Zip Code:42431-2794
Practice Address - Country:US
Practice Address - Phone:270-821-9451
Practice Address - Fax:270-821-0242
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-07
Last Update Date:2008-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY310237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist