Shanon Lee Mekesa Ellis, NP-C
Nurse Practitioner, Family in Willoughby, OH. Individual provider (NPI-1).
NPI number1043781925
StatusActive
Last updated in NPPESFeb 5, 2020
Details
- NPI
- 1043781925
- Entity type
- Individual (NPI-1)
- Name
- Shanon Lee Mekesa Ellis
- Credential
- NP-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 17, 2018
- Certification date
- Feb 5, 2020
- Last updated
- Feb 5, 2020
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LF0000X | Nurse Practitioner, Family | APRN.CNP.024564 | OH | Yes |
Practice location
6005 Som Center RdWilloughby, OH 44094-9646
Phone 440-946-7252
Mailing address
5725 Deer Creek DrWilloughby, OH 44094-4185
Phone 770-841-3785
Other practice locations
630 E River St
Elyria, OH 44035-5902
Elyria, OH 44035-5902
Phone 440-326-4217
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All 35 Family Nurse Practitioner providers in Willoughby · All 1,404 providers in Willoughby
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