Provider Demographics
NPI:1912192048
Name:ELSON, LONNY DAVID (NP)
Entity Type:Individual
Prefix:MR
First Name:LONNY
Middle Name:DAVID
Last Name:ELSON
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 W UNIVERSITY AVE STE 206
Mailing Address - Street 2:
Mailing Address - City:FLAGSTAFF
Mailing Address - State:AZ
Mailing Address - Zip Code:86001-2996
Mailing Address - Country:US
Mailing Address - Phone:928-266-1530
Mailing Address - Fax:928-438-6637
Practice Address - Street 1:1016 W UNIVERSITY AVE STE 206
Practice Address - Street 2:
Practice Address - City:FLAGSTAFF
Practice Address - State:AZ
Practice Address - Zip Code:86001-2996
Practice Address - Country:US
Practice Address - Phone:928-266-1530
Practice Address - Fax:928-438-6637
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ293605363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care