Provider Demographics
NPI:1295596229
Name:MCELVAIN, GESAMAE JOCSING (NP)
Entity type:Individual
Prefix:
First Name:GESAMAE
Middle Name:JOCSING
Last Name:MCELVAIN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5103 ROBERT WAYNE DR
Mailing Address - Street 2:
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-7810
Mailing Address - Country:US
Mailing Address - Phone:916-895-9190
Mailing Address - Fax:
Practice Address - Street 1:5103 ROBERT WAYNE DR
Practice Address - Street 2:
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-7810
Practice Address - Country:US
Practice Address - Phone:916-895-9190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-17
Last Update Date:2024-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61519703363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner