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NPI Code Detail

MEDICARE: PATTI A ELLISON

MEDICARE: PATTI A ELLISON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseRN.166532OH
2363L00000XNurse PractitionerAPRN.CNP.04386OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144260035
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATTI A ELLISON
Provider Business Mailing Address
First Line : 6460 HARRISON AVE STE 200
Second Line :
City : CINCINNATI
State : OH
Zip : 45247-7958
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Provider Business Practice Location Address
First Line : 25 WHITNEY DR STE 122
Second Line :
City : MILFORD
State : OH
Zip : 45150-8400
Country : US
Telephone Number : 513-941-4999
Fax Number : 513-694-0168
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2006
Last Update Date : 11/12/2024

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Directions to “ PATTI A ELLISON ” Practice Location

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