Basic Information
| Provider Information | |||||||||
| NPI: | 1841455250 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | ELKINS | ||||||||
| FirstName: | MARLA | ||||||||
| MiddleName: | DAWN | ||||||||
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| Credential: | N.P. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1301 W PANOLA ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756332345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305270414 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1301 W PANOLA ST | ||||||||
| Address2: | |||||||||
| City: | CARTHAGE | ||||||||
| State: | TX | ||||||||
| PostalCode: | 756332345 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5305270414 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2008 | ||||||||
| LastUpdateDate: | 11/19/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/19/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP2300X | NPF18020 | CA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Primary Care | 163W00000X | RN60414528 | WA | N | Nursing Service Providers | Registered Nurse | 363L00000X | APN.0991396-NP | CO | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363L00000X | AP60414530 | WA | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | 363LF0000X | AP126137 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.