Provider Demographics
NPI:1831087485
Name:ELLIOTT, KRISTI (CHW)
Entity type:Individual
Prefix:MS
First Name:KRISTI
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODS CIR STE 200
Mailing Address - Street 2:
Mailing Address - City:ALPENA
Mailing Address - State:MI
Mailing Address - Zip Code:49707-1443
Mailing Address - Country:US
Mailing Address - Phone:989-358-7971
Mailing Address - Fax:989-358-7971
Practice Address - Street 1:100 WOODS CIR STE 200100
Practice Address - Street 2:
Practice Address - City:ALPENA
Practice Address - State:MI
Practice Address - Zip Code:49707-1444
Practice Address - Country:US
Practice Address - Phone:989-358-7971
Practice Address - Fax:989-356-9080
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-24
Last Update Date:2025-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker