Ellison, Carly

Ellison, Carly is an individual health care provider with primary practice located at 2901 Old Jacksonville Rd , Springfield IL 62704-7437. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Physician Assistants & Advanced Practice Nursing Providers / Primary Care is her primary health care specialty. Ellison, Carly can be contacted via phone (217) 698-9722.

Contact Information

Primary practice address
2901 Old Jacksonville Rd Springfield IL 62704-7437
Phone: (217) 698-9722
Fax: (217) 391-0392
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 209012884 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Primary Care 363LP2300X 209012884 Illinois

Profile Details

NPI number 1508245028
LBN Legal business name Ellison, Carly
Credentials Advanced Practice Nurse (APN)
Entity Individual
Sole proprietor 1 No
Enumeration date May 29th, 2015
Last updated Apr 18th, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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