Provider Demographics
NPI:1154714483
Name:PAGE, ELLEN ELIZABETH (RN)
Entity type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:ELIZABETH
Last Name:PAGE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4890 ANNETTE PLACE
Mailing Address - Street 2:
Mailing Address - City:WARRENSVILLE HTS
Mailing Address - State:OH
Mailing Address - Zip Code:44128-4722
Mailing Address - Country:US
Mailing Address - Phone:216-548-2084
Mailing Address - Fax:216-581-0868
Practice Address - Street 1:4890 ANNETTE PLACE
Practice Address - Street 2:
Practice Address - City:WARRENSVILLE HTS
Practice Address - State:OH
Practice Address - Zip Code:44128-4722
Practice Address - Country:US
Practice Address - Phone:216-548-2084
Practice Address - Fax:216-581-0868
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN-296973163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse