Provider Demographics
NPI:1871695494
Name:ELWARTOWSKI, NANCY A (DC)
Entity type:Individual
Prefix:DR
First Name:NANCY
Middle Name:A
Last Name:ELWARTOWSKI
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:COOPER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:75 EXECUTIVE DR.
Mailing Address - Street 2:SUITE J
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-853-6666
Mailing Address - Fax:317-853-6666
Practice Address - Street 1:75 EXECUTIVE DR.
Practice Address - Street 2:SUITE J
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-853-6666
Practice Address - Fax:317-853-6666
Is Sole Proprietor?:No
Enumeration Date:2006-09-03
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08001113111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200922000AMedicaid
IN200922000AMedicaid
313850Medicare PIN