Provider Demographics
NPI:1386374783
Name:ELLIOTT, AMY LEIGH (FNP-BC)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:LEIGH
Last Name:ELLIOTT
Suffix:
Gender:
Credentials:FNP-BC
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:LEIGH
Other - Last Name:CLARK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1000 FM 300
Mailing Address - Street 2:
Mailing Address - City:LEVELLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79336-6235
Mailing Address - Country:US
Mailing Address - Phone:806-894-7842
Mailing Address - Fax:806-300-8650
Practice Address - Street 1:1502 N AVENUE K
Practice Address - Street 2:
Practice Address - City:LAMESA
Practice Address - State:TX
Practice Address - Zip Code:79331-3040
Practice Address - Country:US
Practice Address - Phone:806-872-3069
Practice Address - Fax:806-894-3378
Is Sole Proprietor?:No
Enumeration Date:2022-06-16
Last Update Date:2025-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1049974363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily