Provider Demographics
NPI:1740676048
Name:ELKING, NICOLE A (APRN-CNP)
Entity type:Individual
Prefix:
First Name:NICOLE
Middle Name:A
Last Name:ELKING
Suffix:
Gender:F
Credentials:APRN-CNP
Other - Prefix:
Other - First Name:NICOLE
Other - Middle Name:A
Other - Last Name:OWENS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:APRN-CNP
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-685-8074
Mailing Address - Fax:614-685-6492
Practice Address - Street 1:460 W 10TH AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43210-1240
Practice Address - Country:US
Practice Address - Phone:614-293-4969
Practice Address - Fax:614-293-6111
Is Sole Proprietor?:No
Enumeration Date:2015-04-13
Last Update Date:2021-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.17832363LA2100X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0141795Medicaid
OHH429461Medicare PIN
OH0141795Medicaid