Provider Demographics
NPI:1013295096
Name:KAHN, ELANA MIRIAM (CNM)
Entity Type:Individual
Prefix:MRS
First Name:ELANA
Middle Name:MIRIAM
Last Name:KAHN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5245 E FLETCHER AVE
Mailing Address - Street 2:
Mailing Address - City:TEMPLE TERRACE
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1126
Mailing Address - Country:US
Mailing Address - Phone:813-914-7304
Mailing Address - Fax:813-914-7314
Practice Address - Street 1:5245 E FLETCHER AVE
Practice Address - Street 2:
Practice Address - City:TEMPLE TERRACE
Practice Address - State:FL
Practice Address - Zip Code:33617-1126
Practice Address - Country:US
Practice Address - Phone:813-676-8842
Practice Address - Fax:813-676-8815
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-25
Last Update Date:2024-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11004220367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife