| NPI | 1104133206 |
|---|---|
| Former Name | JANET L ELLISON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: NY 401968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 336982) |
| 363LF0000X Nurse Practitioner, Family (Licence: NY F336982) | |
| 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: CT 5661) | |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2022-04-29 |