Provider Demographics
NPI:1699256958
Name:RADCLIFFE, ELLA MARGARET (RN, NP)
Entity type:Individual
Prefix:
First Name:ELLA
Middle Name:MARGARET
Last Name:RADCLIFFE
Suffix:
Gender:F
Credentials:RN, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:315 MANCHESTER AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37206-2423
Mailing Address - Country:US
Mailing Address - Phone:404-797-7808
Mailing Address - Fax:
Practice Address - Street 1:27005 76TH AVE RM 327
Practice Address - Street 2:
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11040-1496
Practice Address - Country:US
Practice Address - Phone:718-470-4034
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF308894363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care