Provider Demographics
NPI:1871003509
Name:NAVA, ELENA LORRAINE (MMS, PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELENA
Middle Name:LORRAINE
Last Name:NAVA
Suffix:
Gender:F
Credentials:MMS, PA-C
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Mailing Address - Street 1:141 LACY ST NW STE 200
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30060-1118
Mailing Address - Country:US
Mailing Address - Phone:678-501-7092
Mailing Address - Fax:770-426-7745
Practice Address - Street 1:141 LACY ST NW STE 200
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1118
Practice Address - Country:US
Practice Address - Phone:770-426-7177
Practice Address - Fax:770-426-7745
Is Sole Proprietor?:No
Enumeration Date:2017-10-09
Last Update Date:2017-10-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA8541363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant