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SUSAN ELLIS PMHNP NPI 1750706800


NPI Information

NPI: 1750706800
Provider Name: SUSAN ELLIS, PMHNP
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
1937 W HARVARD AVE
ROSEBURG, OR
ZIP 97471
Phone: (541) 677-7200
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Susan Ellis, PMHNP is a psychiatric/mental health nurse practitioner in Roseburg, OR with 8 years of experience. Susan Ellis, PMHNP NPI is 1750706800. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: UNIVERSITY OF ARIZONA COLLEGE OF MEDICINE
Graduation Year:2016

The provider's business location address is:

1937 W HARVARD AVE
ROSEBURG, OR
ZIP 97471-720
Phone: (541) 677-7200
Fax: (541) 229-3309

The NPI 1750706800 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 2/26/2014 and was last updated on 12/28/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental Health202114835NP-PPOREGONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.