Provider Demographics
NPI:1013749704
Name:ELAM, KARI L
Entity type:Individual
Prefix:
First Name:KARI
Middle Name:L
Last Name:ELAM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8177 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5744
Mailing Address - Country:US
Mailing Address - Phone:440-622-3136
Mailing Address - Fax:440-290-8691
Practice Address - Street 1:8177 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-5744
Practice Address - Country:US
Practice Address - Phone:440-622-3136
Practice Address - Fax:440-290-8691
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-20
Last Update Date:2024-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker