Provider Demographics
NPI:1841422367
Name:SEARLE, ELAINE M (APRN)
Entity Type:Individual
Prefix:MRS
First Name:ELAINE
Middle Name:M
Last Name:SEARLE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 NEWELL RD
Mailing Address - Street 2:SUITE E36
Mailing Address - City:BRISTOL
Mailing Address - State:CT
Mailing Address - Zip Code:06010-5100
Mailing Address - Country:US
Mailing Address - Phone:860-583-9292
Mailing Address - Fax:860-585-9848
Practice Address - Street 1:25 NEWELL RD
Practice Address - Street 2:SUITE E36
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06010-5100
Practice Address - Country:US
Practice Address - Phone:860-583-9292
Practice Address - Fax:860-585-9848
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-17
Last Update Date:2009-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT004141363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily