Healthcare Provider Details

I. General information

NPI: 1437920238
Provider Name (Legal Business Name): ELLEN WAMSLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

272 HOSPITAL RD
CHILLICOTHEE OH
45601-9031
US

IV. Provider business mailing address

2481 POWELL AVE
COLUMBUS OH
43209-1748
US

V. Phone/Fax

Practice location:
  • Phone: 740-779-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License NumberAPRN.CRNA.0021610
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: