Individual
LISA MARIE ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3335 PACIFIC DR, NAPLES, FL 34119-8665
(425) 985-0506
Mailing address
3335 PACIFIC DR, NAPLES, FL 34119-8665
(425) 985-0506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN9525412
FL
163WN1003X
Nutrition Support Registered Nurse
RN9525412
FL
Other
Enumeration date
03/27/2023
Last updated
03/27/2023
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