Provider Demographics
NPI:1740702893
Name:PELTON, ELAINA NICOLE (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELAINA
Middle Name:NICOLE
Last Name:PELTON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:ELAINA
Other - Middle Name:NICOLE
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:600 SAINT JOHNSBURY RD
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:NH
Mailing Address - Zip Code:03561-3442
Mailing Address - Country:US
Mailing Address - Phone:034-449-2946
Mailing Address - Fax:
Practice Address - Street 1:580 SAINT JOHNSBURY RD
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:NH
Practice Address - Zip Code:03561-3437
Practice Address - Country:US
Practice Address - Phone:603-444-9294
Practice Address - Fax:603-444-9025
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2023-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0005027207Q00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine