Elite RN PC

Primary specialty

Acute Care Clinical Nurse SpecialistTaxonomy code 364SA2100X

License

50268 Issued in OK

Legal business name

ELITE RN PC

Practice address

3568 McClaflin Dr
Enid, OK 73701-7745

Phone

(580) 402-1635

Fax

(580) 233-2131

NPI assigned

Jul 4, 2011

Last updated

Jul 11, 2011By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Teresa Jeanne Etter, CCNSRX

Title

President

Phone

(580) 402-1635

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1309737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1310342400000",
    "number": "1982991519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3031",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737023031",
            "telephone_number": "580-237-2327",
            "fax_number": "580-237-2339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3568 MCCLAFLIN DR",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017745",
            "telephone_number": "580-402-1635",
            "fax_number": "580-233-2131"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE RN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-07-04",
        "last_updated": "2011-07-11",
        "status": "A",
        "authorized_official_last_name": "ETTER",
        "authorized_official_first_name": "TERESA",
        "authorized_official_middle_name": "JEANNE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "580-402-1635",
        "authorized_official_credential": "CCNSRX"
    },
    "taxonomies": [
        {
            "code": "364SA2100X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Clinical Nurse Specialist, Acute Care",
            "state": "OK",
            "license": "50268",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200281660A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Acute Care Clinical Nurse Specialist in Enid, OK
• Providers in Enid, OK by specialty
• Acute Care Clinical Nurse Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2011; 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.