Provider Demographics
NPI:1679947006
Name:ELLIOT, SARAH L (MSN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:SARAH
Middle Name:L
Last Name:ELLIOT
Suffix:
Gender:F
Credentials:MSN, FNP-C
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Mailing Address - Street 1:150 S HUNTINGTON AVE
Mailing Address - Street 2:VA BOSTON HEALTHCARE SYSTEM (C&P/11)
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02130-4817
Mailing Address - Country:US
Mailing Address - Phone:857-364-5569
Mailing Address - Fax:857-364-6016
Practice Address - Street 1:200 W SUMMIT AVE STE 290
Practice Address - Street 2:
Practice Address - City:WALES
Practice Address - State:WI
Practice Address - Zip Code:53183-9427
Practice Address - Country:US
Practice Address - Phone:844-726-3926
Practice Address - Fax:844-726-3926
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2023-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI135512-30163W00000X
MECNP151175363LF0000X
WI7556-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse