Elliott, Jerry G
Elliott, Jerry G is an sole proprietor health care provider with primary practice located at 888 Swift Blvd , Richland WA 99352. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Elliott, Jerry G can be contacted via phone (509) 946-9611.Contact Information
Primary practice address
888 Swift Blvd
Richland WA 99352
Phone: (509) 946-9611
Fax: (509) 942-2185
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | N-35393 | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | NP-917A | Idaho |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP60240764 | Washington |
Profile Details
| NPI number | 1114152758 |
|---|---|
| LBN Legal business name | Elliott, Jerry G |
| Credentials | NP-C |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | May 27th, 2009 |
| Last updated | Nov 8th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1114152758 | NPPES |
| Idaho | MEDICAID | 002803300 |
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