Provider Demographics
NPI:1215725189
Name:ELLIOTT, ESSENCE
Entity type:Individual
Prefix:
First Name:ESSENCE
Middle Name:
Last Name:ELLIOTT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:176 WEXFORD DR E
Mailing Address - Street 2:
Mailing Address - City:SUFFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23434-9114
Mailing Address - Country:US
Mailing Address - Phone:757-901-3247
Mailing Address - Fax:
Practice Address - Street 1:176 WEXFORD DR E
Practice Address - Street 2:
Practice Address - City:SUFFOLK
Practice Address - State:VA
Practice Address - Zip Code:23434-9114
Practice Address - Country:US
Practice Address - Phone:757-901-3247
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant