Provider Demographics
NPI:1255143657
Name:LONNEMANN, ELLIOTT FRANCIS
Entity type:Individual
Prefix:
First Name:ELLIOTT
Middle Name:FRANCIS
Last Name:LONNEMANN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7812 SAINT JOHNS RD
Mailing Address - Street 2:
Mailing Address - City:FLOYDS KNOBS
Mailing Address - State:IN
Mailing Address - Zip Code:47119-8538
Mailing Address - Country:US
Mailing Address - Phone:812-786-7649
Mailing Address - Fax:
Practice Address - Street 1:7812 SAINT JOHNS RD
Practice Address - Street 2:
Practice Address - City:FLOYDS KNOBS
Practice Address - State:IN
Practice Address - Zip Code:47119-8538
Practice Address - Country:US
Practice Address - Phone:812-786-7649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program