Individual
CARLY ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
7900 E UNION AVE STE 1100, DENVER, CO 80237-2746
(303) 414-1164
(813) 906-7789
Mailing address
2901 OLD JACKSONVILLE RD, SPRINGFIELD, IL 62704-7437
(217) 698-9722
(217) 391-0392
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
209012884
IL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
C-APN.0003842-C-NP
CO
363LP2300X
Primary Care Nurse Practitioner
209012884
IL
Other
Enumeration date
05/29/2015
Last updated
04/30/2025
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