Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MS. LISA ANNETTE ELLINGWOOD, APRN, PMHNP-BC
Active Sole ProprietorMS. LISA ANNETTE ELLINGWOOD, APRN, PMHNP-BC is a Psychiatric/Mental Health Nurse Practitioner healthcare provider located in CHAMPAIGN, Illinois. NPI 1083255343 is currently active in the NPPES registry. Verify at CMS.
Psychiatric/Mental Health Nurse Practitioner · CHAMPAIGN, IL
Registration Details
- NPI Number
- 1083255343
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Oct 7, 2019 (6.814262821635 yrs)
- Last Updated
- Apr 22, 2024
- Licenses
-
041.385774 (IL)209.020407 (IL)
- Sole Proprietor
- Yes
Practice Information
- Address
-
1802 S MATTIS AVECHAMPAIGN, IL, 618215923Browse IL providers · Browse ZIP 61821
- Phone
- 2173652855
- Fax
- 2173652856
- Primary Specialty
-
Psychiatric/Mental Health Nurse Practitioner
363LP0808X
- Additional Specialty
- Psychiatric/Mental Health Nurse Practitioner
Other Psychiatric/Mental Health Nurse Practitioner Providers in CHAMPAIGN, IL
| Name | Credential | NPI |
|---|---|---|
| JACQUELINE ANN BODE | APN | 1245572213 |
| HEATHER RENEE IRELAN | PMHNP-BC, FNP-C | 1881139905 |
| RAKISHA WILKS | NP | 1841843539 |
| BRADLEY THOMPSON | APRN-CNP | 1982230124 |
| MR. DANIEL THOMAS FOUTCH | APRN, PMHNP-BC | 1669149134 |
| IKECHUKWU UZOARU JR. | CNP | 1457001463 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.