Provider Demographics
NPI:1063969699
Name:ELFRINK, JULIE (RN)
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:
Last Name:ELFRINK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 N. HWY 51
Mailing Address - Street 2:
Mailing Address - City:MARBLE HILL
Mailing Address - State:MO
Mailing Address - Zip Code:63764
Mailing Address - Country:US
Mailing Address - Phone:573-238-2817
Mailing Address - Fax:573-238-3085
Practice Address - Street 1:107 N. HWY 51
Practice Address - Street 2:
Practice Address - City:MARBLE HILL
Practice Address - State:MO
Practice Address - Zip Code:63764
Practice Address - Country:US
Practice Address - Phone:573-238-2817
Practice Address - Fax:573-238-3085
Is Sole Proprietor?:No
Enumeration Date:2016-09-01
Last Update Date:2016-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO113762163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse