Provider Demographics
NPI:1982198131
Name:ELLIOTT, KARI L (DNP, CPNP-PC, AE-C)
Entity Type:Individual
Prefix:DR
First Name:KARI
Middle Name:L
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DNP, CPNP-PC, AE-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2925 CLINTON RD
Mailing Address - Street 2:
Mailing Address - City:SEDALIA
Mailing Address - State:MO
Mailing Address - Zip Code:65301-7915
Mailing Address - Country:US
Mailing Address - Phone:660-829-5852
Mailing Address - Fax:660-829-5854
Practice Address - Street 1:1058 COLLEGE DR
Practice Address - Street 2:
Practice Address - City:NEW TOWN
Practice Address - State:ND
Practice Address - Zip Code:58763-9112
Practice Address - Country:US
Practice Address - Phone:701-627-1450
Practice Address - Fax:701-627-2809
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2021-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018020187208000000X, 2080A0000X, 363LN0000X, 363LP0200X
MO2021039624363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal