Individual
MS. ELLEN EDITH MOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
19067 W FRONTAGE RD, RAYMOND, IL 62560-5053
(866) 309-1160
(217) 475-5055
Mailing address
19067 W FRONTAGE RD, RAYMOND, IL 62560-5053
(866) 309-1160
(217) 475-5055
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
209011105
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2018080836
ANCC PSYCHIATRIC-MENTAL HEALTH NURSE PRACTITIONER PMHNP-BC
IL
01
—
201905482NP-PP
LICENSE
OR
Enumeration date
01/15/2014
Last updated
01/15/2026
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