Sandra L Elliott, F.N.P.

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704077181 Issued in MI

Practice address

39350 9 Mile Rd
Northville, MI 48167-9164

Phone

(248) 425-5149

NPI assigned

Aug 10, 2005

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1123632000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232409600000",
    "number": "1699777649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 HI DALE DR",
            "city": "LAKE ORION",
            "state": "MI",
            "postal_code": "483602422",
            "telephone_number": "248-391-0114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39350 9 MILE RD",
            "city": "NORTHVILLE",
            "state": "MI",
            "postal_code": "481679164",
            "telephone_number": "248-425-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "SANDRA",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "F.N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-10",
        "last_updated": "2009-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704077181",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4476822",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Northville, MI
• Providers in Northville, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2009; 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.