Latifah Elliott, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN307969 Issued in PA

Practice address

960 Harvest Dr
#100
Blue Bell, PA 19422

Phone

(215) 605-9336

NPI assigned

Mar 16, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1647388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647388800000",
    "number": "1457009516",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "118 S AMERICAN ST",
            "city": "WOODBURY",
            "state": "NJ",
            "postal_code": "080962108",
            "telephone_number": "215-606-9336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "960 HARVEST DR",
            "address_2": "#100",
            "city": "BLUE BELL",
            "state": "PA",
            "postal_code": "19422",
            "telephone_number": "215-605-9336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "LATIFAH",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-03-16",
        "last_updated": "2022-03-16",
        "certification_date": "2022-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "PA",
            "license": "PN307969",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "latifah.elliott@kencrest.org",
            "affiliation": "N",
            "endpointDescription": "kencrest.org",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "960 Harvest Dr",
            "address_2": "#100",
            "city": "Blue Bell",
            "state": "PA",
            "country_code": "US",
            "postal_code": "19422",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Licensed Practical Nurse in Blue Bell, PA
• Providers in Blue Bell, PA by specialty
• Licensed Practical Nurse in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.