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NPI Code Detail

MEDICARE: MICHELLE ELLER CNP

MEDICARE: MICHELLE ELLER CNP
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerAPRN.CNP.021545OH

General Provider Information

NPI Number : 1669564480
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE ELLER CNP
Provider Business Mailing Address
First Line : 5982 RHODES RD
Second Line :
City : KENT
State : OH
Zip : 44240-8100
Country : US
Telephone Number : 330-673-1347
Fax Number : 330-678-3677
Provider Business Practice Location Address
First Line : 5982 RHODES RD
Second Line :
City : KENT
State : OH
Zip : 44240-8100
Country : US
Telephone Number : 330-673-1347
Fax Number : 330-678-3677
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 06/10/2020

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