Provider Demographics
NPI:1336395862
Name:FELICIANO, ELENA MARIA (DO)
Entity Type:Individual
Prefix:
First Name:ELENA
Middle Name:MARIA
Last Name:FELICIANO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:321 BILLINGSLY CT
Mailing Address - Street 2:SUITE 5
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-6444
Mailing Address - Country:US
Mailing Address - Phone:615-778-0509
Mailing Address - Fax:615-613-1449
Practice Address - Street 1:321 BILLINGSLY CT
Practice Address - Street 2:SUITE 5
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-6444
Practice Address - Country:US
Practice Address - Phone:615-778-0509
Practice Address - Fax:615-613-1449
Is Sole Proprietor?:No
Enumeration Date:2008-08-15
Last Update Date:2014-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101017780207P00000X, 207R00000X
NY257269207Q00000X
FLOS11554207Q00000X
TN2521207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine