Provider Demographics
NPI:1477697977
Name:ELMS, KRISTI ANN (PT)
Entity type:Individual
Prefix:MRS
First Name:KRISTI
Middle Name:ANN
Last Name:ELMS
Suffix:
Gender:F
Credentials:PT
Other - Prefix:MS
Other - First Name:KRISTI
Other - Middle Name:ANN
Other - Last Name:BROWN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:1104 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BENTON
Mailing Address - State:IL
Mailing Address - Zip Code:62812-1565
Mailing Address - Country:US
Mailing Address - Phone:618-439-3399
Mailing Address - Fax:717-635-4685
Practice Address - Street 1:1138 W MCCORD ST
Practice Address - Street 2:
Practice Address - City:CENTRALIA
Practice Address - State:IL
Practice Address - Zip Code:62801-5603
Practice Address - Country:US
Practice Address - Phone:618-352-1310
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-16
Last Update Date:2025-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL070-012070225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist