Provider Demographics
NPI:1336771013
Name:ELLIOTT, STEPHANIE MILLER (DNP)
Entity type:Individual
Prefix:DR
First Name:STEPHANIE
Middle Name:MILLER
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1312 17TH ST UNIT 2584
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80202-1508
Mailing Address - Country:US
Mailing Address - Phone:720-248-7170
Mailing Address - Fax:
Practice Address - Street 1:1776 CURTIS ST APT 1710
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80202-2554
Practice Address - Country:US
Practice Address - Phone:225-337-2381
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2023-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COAPN.0998702-NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX410823501Medicaid
TX410823502OtherCSHCN