Individual
JEANETTE LEANN ELLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-C
Contact information
Practice address
2824 E DONNER DR, PHOENIX, AZ 85042-6069
(602) 448-8146
Mailing address
2824 E DONNER DR, PHOENIX, AZ 85042-6069
(602) 448-8146
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
254185
AZ
Other
Enumeration date
09/11/2025
Last updated
09/11/2025
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