Most Relevant Information
Provider Data
| NPI Number: | 1003413519 |
| Provider Name: | DEANDRA ELLIOTT |
| Entity Type: | Individual |
| Taxonomy Code: | 171M00000X |
| Specialty: | Case Manager/Care Coordinator |
| License Number: |
Most Important Dates
| Enumeration Date: | 10/07/2020 |
| Last Updated: | 10/07/2020 |
Provider Practice Location
2346 S LYNHURST DR STE 200
INDIANAPOLIS
IN
462415135
Practice Location Phone/Fax
| Phone: | 3176981667 |
| Fax: |
Provider Mailing Location
2346 S LYNHURST DR STE 200
INDIANAPOLIS
IN
462415135
Provider Mailing Phone/Fax
| Phone: | 3176981667 |
| Fax: |