Iacovone, Ellen M

Iacovone, Ellen M is an individual health care provider with primary practice located at 12300 Mccracken Rd , Garfield Hts OH 44125-2914. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Iacovone, Ellen M can be contacted via phone (216) 581-0500.

Contact Information

Primary practice address
12300 Mccracken Rd Garfield Hts OH 44125-2914
Phone: (216) 581-0500
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X NP-03023 Ohio

Profile Details

NPI number 1134107204
LBN Legal business name Iacovone, Ellen M
Credentials Certified Nurse Practitioner (CNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2006
Last updated Jul 11th, 2007 - about 17 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 1134107204 NPPES
Ohio Other 000000324165 ANTHEM
Ohio MEDICAID 2185862 ANTHEM

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