Ellingwood, Lisa Annette

Ellingwood, Lisa Annette is an sole proprietor health care provider with primary practice located at 1802 S Mattis Ave , Champaign IL 61821-5923. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Ellingwood, Lisa Annette can be contacted via phone (217) 365-2855.

Contact Information

Primary practice address
1802 S Mattis Ave Champaign IL 61821-5923
Phone: (217) 365-2855
Fax: (217) 365-2856
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 041.385774 Illinois
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 209.020407 Illinois

Profile Details

NPI number 1083255343
LBN Legal business name Ellingwood, Lisa Annette
Credentials APRN, PMHNP-BC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 7th, 2019
Last updated Apr 22nd, 2024 - about 2 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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