Individual
MRS. EBONY MARIE ELAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5294 MAYFIELD RD, LYNDHURST, OH 44124-2471
(216) 799-1136
Mailing address
466 TREBISKY RD, RICHMOND HTS, OH 44143-2823
(216) 799-1136
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
F0315410
OH
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17243
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2496062
—
OH
Enumeration date
03/30/2007
Last updated
06/17/2024
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