Individual
MRS. COURTNEY DYAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5172 LEAVITT RD, LORAIN, OH 44053-2384
(440) 282-7420
Mailing address
5172 LEAVITT RD, LORAIN, OH 44053-2384
(440) 282-7420
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
COA.18102-NP
OH
Other
Enumeration date
10/07/2015
Last updated
10/07/2015
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