Provider Demographics
NPI:1215163647
Name:STRATTON, ELAINA MARIE
Entity type:Individual
Prefix:
First Name:ELAINA
Middle Name:MARIE
Last Name:STRATTON
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 1:18915 W 12 MILE RD
Mailing Address - Street 2:
Mailing Address - City:LATHRUP VILLAGE
Mailing Address - State:MI
Mailing Address - Zip Code:48076-2575
Mailing Address - Country:US
Mailing Address - Phone:248-416-1100
Mailing Address - Fax:248-416-1102
Practice Address - Street 1:18915 W 12 MILE RD
Practice Address - Street 2:
Practice Address - City:LATHRUP VILLAGE
Practice Address - State:MI
Practice Address - Zip Code:48076-2575
Practice Address - Country:US
Practice Address - Phone:248-416-1100
Practice Address - Fax:248-416-1102
Is Sole Proprietor?:No
Enumeration Date:2009-05-29
Last Update Date:2009-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide