Individual
MR. DONALD DEAN ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP-BC
Contact information
Practice address
800 PRUDENTIAL DR, TOWER B, 11TH FLOOR, JACKSONVILLE, FL 32207-8202
(904) 388-6518
(904) 384-1005
Mailing address
800 PRUDENTIAL DR, TOWER B, 11TH FLOOR, JACKSONVILLE, FL 32207-8202
(904) 388-6518
(904) 384-1005
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
ARNP2151382
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
309007800
—
FL
Enumeration date
03/05/2008
Last updated
06/08/2016
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