Provider Demographics
NPI:1366871857
Name:EKMARK, ELAINE (MS, RN, SNP-BC, CWCN)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:EKMARK
Suffix:
Gender:F
Credentials:MS, RN, SNP-BC, CWCN
Other - Prefix:
Other - First Name:ELAINE
Other - Middle Name:MCGARR
Other - Last Name:EKMARK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2222 WELBORN ST
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75219-3924
Mailing Address - Country:US
Mailing Address - Phone:214-559-5000
Mailing Address - Fax:214-443-7309
Practice Address - Street 1:2222 WELBORN ST
Practice Address - Street 2:TEXAS SCOTTISH RITE HOSPITAL
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75219-3924
Practice Address - Country:US
Practice Address - Phone:214-559-5000
Practice Address - Fax:214-443-7309
Is Sole Proprietor?:No
Enumeration Date:2013-11-05
Last Update Date:2015-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX228674363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner