Provider Demographics
NPI:1396455184
Name:ELAM CANTY, MASHANDRA (DNP, MSN, BSN)
Entity type:Individual
Prefix:DR
First Name:MASHANDRA
Middle Name:
Last Name:ELAM CANTY
Suffix:
Gender:F
Credentials:DNP, MSN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4727 RITSON LN
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28306-9751
Mailing Address - Country:US
Mailing Address - Phone:210-836-5257
Mailing Address - Fax:
Practice Address - Street 1:4727 RITSON LN
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28306-9751
Practice Address - Country:US
Practice Address - Phone:210-836-5257
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-12-01
Last Update Date:2022-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX680208364SP1700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP1700XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPerinatal