Provider Demographics
NPI:1700105673
Name:BRIGGS, ELAINE DIANE (DNP,APRN, FNP-BC)
Entity Type:Individual
Prefix:DR
First Name:ELAINE
Middle Name:DIANE
Last Name:BRIGGS
Suffix:
Gender:F
Credentials:DNP,APRN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10895 GREENLEFE DR
Mailing Address - Street 2:
Mailing Address - City:ROLLA
Mailing Address - State:MO
Mailing Address - Zip Code:65401-7403
Mailing Address - Country:US
Mailing Address - Phone:573-368-1861
Mailing Address - Fax:
Practice Address - Street 1:10895 GREENLEFE DR
Practice Address - Street 2:
Practice Address - City:ROLLA
Practice Address - State:MO
Practice Address - Zip Code:65401-7403
Practice Address - Country:US
Practice Address - Phone:573-368-1861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-18
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014013363LF0000X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO132130023Medicare PIN