ELLEN L LARUSSO (NPI# 1427263383) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427263383 |
| Entity Type | Individual |
| Full Name | ELLEN L LARUSSO |
| Credential | APRN |
| Practice Address |
301 Memorial Medical Pkwy Daytona Beach FL 32117-5167 |
| Mailing Address |
5220 Belfort Rd Ste 103 Jacksonville FL 32256-6017 |
| Practice Telephone | 3862313615 |
| Practice Fax Number | 3862313614 |
| Mailing Telephone | 9044463424 |
| Mailing Fax Number | 9044433369 |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2018-12-20 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
9428863 | FL | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
5009587 | NC | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
F335300-1 | NY | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1540 Sunday Dr, Raleigh, NC 276076010 | 9197823456 | 9197831441 |
| 736 Irving Avenue, Syracuse, NY 13210 | 3154107111 |
| Street Address |
301 MEMORIAL MEDICAL PKWY |
| City | DAYTONA BEACH |
| State | FL |
| Zip Code | 32117-5167 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1972588788 | Kathleen Ann Williams | Internal Medicine | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2005-12-14 |
| 1790385029 | James Edward Collie | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-10-27 |
| 1568077501 | Christian H Schadt | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-09-15 |
| 1982220620 | Olatoun Okediji | Social Worker | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-06-18 |
| 1962038554 | Maria Clea Dulay | Physical Therapist | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-03-16 |
| 1659907244 | Lisa Wisniewski | Physical Therapist | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2020-03-16 |
| 1386287506 | Kristin Warner | Registered Nurse | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2019-10-21 |
| 1841832797 | Morgan Nicole Miles | Hospitalist | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2019-10-11 |
| 1508329780 | Samantha Snowden | Nurse Practitioner | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2019-04-13 |
| 1114489812 | Lindsay Schneider | Physician Assistant | 301 Memorial Medical Pkwy, Daytona Beach, FL 32117-5167 | 2019-04-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992350409 | Erin Selfridge | Pharmacist | 1500 Beville Rd #300, Daytona Beach, FL 32117 | 2019-08-02 |
| 1881185494 | Wellspring Health, LLC | Chiropractor | 701 Ridgewood Ave, Holly Hills, FL 32117 | 2018-05-21 |
| 1780172791 | L & L Db, LLC | Clinic/Center | 1540 Cornerstone Blvd, Suite 100, Daytona Beach, FL 32117 | 2018-04-25 |
| 1154837789 | Brittany Nikolow | Nurse Practitioner | 1717 N. Clyde Morris, Daytona Beach, FL 32117 | 2017-12-19 |
| 1205356946 | Alejandro Andre Pabon Rodriguez | Nurse Anesthetist, Certified Registered | Florida Hospital Memorial Medical Center, 301 Memorial Medical Parkway, Daytona Beach, FL 32117 | 2017-06-23 |
| 1316492135 | Ann Van Herck | Physical Therapist | 1901 Mason Ave Ste 105, Daytona Beach, FL 32117 | 2016-08-22 |
| 1952784779 | Kathryn Brenna Copley | Nurse Practitioner | 1890 Lpga Blvd., Daytona Beach, FL 32117 | 2015-06-30 |
| 1053719559 | Alicia Graham | Case Manager/Care Coordinator | 1570 Megan Bay Circle, Holly Hill, FL 32117 | 2014-12-15 |
| 1578974440 | Halifax Senior Care Inc | Clinic/Center | 1515 Ridgewood Ave, Suite B, Holly Hill, FL 32117 | 2014-05-14 |
| 1013345883 | Kist Alf, Inc | Assisted Living Facility | 1516 Carmen Avenue, Daytona Beach, FL 32117 | 2013-10-14 |
| Find all providers in zip 32117 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346840378 | Dee Ann Akers | Nurse Practitioner | 2085 S Halifax Dr, Daytona Beach, FL 32118-5205 | 2020-10-28 |
| 1275140766 | Tolgonay Agamez-morales | Nurse Practitioner | 133 Integra Breeze Ln Unit 303, Daytona Beach, FL 32117-5585 | 2020-09-28 |
| 1144839861 | Amy Decker | Nurse Practitioner | 1329 Tomoka Town Center Dr Apt 102, Daytona Beach, FL 32117-5187 | 2020-07-28 |
| 1629691308 | Johana Daniels | Nurse Practitioner | 1437 Admiral Halsey Ave, Daytona Beach, FL 32124-3614 | 2020-05-28 |
| 1003436189 | Ashley Gillette | Nurse Practitioner | 112 Milton Rd, Daytona Beach, FL 32118-5411 | 2020-04-20 |
| 1871066373 | Tammy Jo Leggett | Nurse Practitioner | 826 N Wild Olive Ave, Daytona Beach, FL 32118-3727 | 2019-01-07 |
| 1184197949 | Maria Vessell | Nurse Practitioner | 311 N Clyde Morris Blvd Ste 550, Daytona Beach, FL 32114-2766 | 2019-01-04 |
| 1518433804 | Tara James | Nurse Practitioner | 224 Seabreeze Blvd, Daytona Beach, FL 32118 | 2018-10-15 |
| 1750899217 | Tayanna Giselle Lawlor | Nurse Practitioner | 1890 Lpga Blvd Ste 170, Daytona Beach, FL 32117-7131 | 2018-01-18 |
| 1871028803 | Susan Kamelgarn | Nurse Practitioner | 104 La Costa Lane, Suite 120, Daytona Beach, FL 32114 | 2017-04-27 |
| Find all providers in DAYTONA BEACH | ||||
| City | DAYTONA BEACH |
| Zip Code | 32117 |
Please comment or provide details below to improve the information on ELLEN L LARUSSO.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.