Ellsworth, Donald Dean

Ellsworth, Donald Dean is an individual health care provider with primary practice located at 800 Prudential Dr Tower B, 11Th Floor, Jacksonville FL 32207-8202. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Acute Care, which is considered as his primary health care specialty. Ellsworth, Donald Dean can be contacted via phone (904) 388-6518.

Contact Information

Primary practice address
800 Prudential Dr Tower B, 11Th Floor Jacksonville FL 32207-8202
Phone: (904) 388-6518
Fax: (904) 384-1005
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X ARNP2151382 Florida

Profile Details

NPI number 1528238540
LBN Legal business name Ellsworth, Donald Dean
Credentials ARNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 5th, 2008
Last updated Jun 8th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1528238540 NPPES
Florida MEDICAID 309007800

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