Provider Demographics
NPI:1114898632
Name:ELLIOTT, STEFANIE NANCY
Entity type:Individual
Prefix:
First Name:STEFANIE
Middle Name:NANCY
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:540 COURT ST # 4090
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11231-3923
Mailing Address - Country:US
Mailing Address - Phone:347-832-5080
Mailing Address - Fax:
Practice Address - Street 1:540 COURT ST # 4090
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11231-3923
Practice Address - Country:US
Practice Address - Phone:347-832-5080
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-16
Last Update Date:2025-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYCPD2025-0828374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula