Shanna Ruth Elliott, DO
Family Medicine in Waterloo, IA. Individual provider (NPI-1).
NPI number1629458302
StatusActive
Last updated in NPPESJun 8, 2015
Details
- NPI
- 1629458302
- Entity type
- Individual (NPI-1)
- Name
- Shanna Ruth Elliott
- Credential
- DO
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2015
- Last updated
- Jun 8, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Q00000X | Family Medicine | R-10280 | IA | Yes |
Practice location
2055 Kimball AveSuite 101
Waterloo, IA 50702
Phone 319-272-2112 · Fax 319-272-2107
Mailing address
2055 Kimball AveSuite 101
Waterloo, IA 50702
Phone 319-272-2112 · Fax 319-272-2107
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