SHIRLEY B ELLSWORTH (NPI# 1942302658) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1942302658 |
| Entity Type | Individual |
| Full Name | SHIRLEY B ELLSWORTH |
| Credential | NP |
| Practice Address |
1055 N 500 W Suite 202 Provo UT 84604-3305 |
| Mailing Address |
1055 N 500 W Credentialing Department Provo UT 84604-3305 |
| Practice Telephone | 8013742367 |
| Practice Fax Number | 8014298015 |
| Mailing Telephone | 8013548215 |
| Mailing Fax Number | 8014298180 |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2007-10-16 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 2629084405 | UT | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
1055 N 500 W SUITE 202 |
| City | PROVO |
| State | UT |
| Zip Code | 84604-3305 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144223835 | Bruce C Mcallister | Specialist | 1055 N 500 W, Suite 102, Provo, UT 84604-3305 | 2005-05-27 |
| 1922641448 | Lilian Silva Dana | Nurse Practitioner | 1055 N 500 W, Suite. 222, Bldg. C, Provo, UT 84604 | 2019-10-28 |
| 1407373574 | Kristie Christensen | Nurse Practitioner | 1055 N 500 W, Ste 101, Bldg C, Provo, UT 84604-3305 | 2017-08-29 |
| 1942664867 | Holly Ann Bishop Michaels | Dietitian, Registered | 1055 N 500 W, Attn. Credentialing, Provo, UT 84604-3305 | 2016-04-06 |
| 1841650967 | Maile Yuzon | Physician Assistant | 1055 N 500 W, Ste 212, Provo, UT 84604-3305 | 2016-03-02 |
| 1497127658 | Kayla Hamrick Lussier | Nurse Practitioner | 1055 N 500 W, Suite 212, Provo, UT 84604-3305 | 2015-10-28 |
| 1962873281 | Ryan Francis | Nurse Practitioner | 1055 N 500 W, Ste 121, Provo, UT 84604-3305 | 2015-10-13 |
| 1083082283 | Leslee Ronald Adams | Registered Nurse | 1055 N 500 W, Ste 211, Provo, UT 84604-3305 | 2015-09-04 |
| 1750763629 | Cydne Suzannah Baird Evans | Physician Assistant | 1055 N 500 W, Ste 100, Provo, UT 84604-3305 | 2015-06-26 |
| 1073903720 | Rosanne Johnson Oliver | Nurse Practitioner | 1055 N 500 W, Ste 205, Provo, UT 84604-3305 | 2015-02-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346882107 | Abigail Belle Hardy | Student in an Organized Health Care Education/Training Program | 1190 900 E, Provo, UT 84604 | 2019-10-14 |
| 1386106698 | Sarah Roseman Hunt | Nurse Practitioner | 1055 N 500 W., Suite. 101, Bldg. C, Provo, UT 84604 | 2019-04-04 |
| 1255813325 | Hwigeum Jeong | Specialist/Technologist | Department of Exercise Sciences 106 Sfh Brigham Young, Provo, UT 84604 | 2018-09-05 |
| 1093203044 | Snowcap Smile Studio LLC | Dentist | 2230 N. University Pkwy Ste 8b, Provo, UT 84604 | 2018-04-25 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1902308455 | Afton Leuga | Nurse Practitioner | 395 W Bulldog Blvd., Suite 401, Provo, UT 84604 | 2018-03-01 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| 1396254165 | Nicolas Sorensen | Massage Therapist | 247 West 2230 North #201, Provo, UT 84604 | 2017-09-25 |
| 1437692241 | Cirque Lodge Inc | Substance Abuse Rehabilitation Facility | 3114 E Ida's Road, Sundance, UT 84604 | 2016-11-28 |
| Find all providers in zip 84604 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619594371 | Aubrie Nicole Carter | Nurse Practitioner | 122 E 1700 S Bldg 3, Provo, UT 84606-5644 | 2020-06-29 |
| 1467535138 | Amanda G Lewis | Nurse Practitioner | 1055 N 300 W Ste 401, Provo, UT 84604-3306 | 2006-10-24 |
| 1699877316 | Steven F Larsen | Nurse Practitioner | 1055 N 500 W Ste 202, Provo, UT 84604-3305 | 2006-09-02 |
| 1215902309 | Marsha K Medford | Nurse Practitioner | 1165 E 300 N, Wasatch Mental Health, Youth Outpatient, Provo, UT 84606-3539 | 2006-02-22 |
| 1417941196 | Tracy Call-schmidt | Nurse Practitioner | 280 River Park Dr Ste 200, Provo, UT 84604-5793 | 2005-09-08 |
| 1417562885 | Mckenzie Hamilton | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2020-09-13 |
| 1700404274 | Riley Wayne Petersen | Nurse Practitioner | 1055 N 500 W Bldg A, Provo, UT 84604-3305 | 2020-07-10 |
| 1770124687 | Kevin Johnson | Nurse Practitioner | 1055 N 500 W Ste 205, Provo, UT 84604-3305 | 2019-10-02 |
| 1770139289 | Cameron Lee Tingey | Nurse Practitioner | 1034 N 500 W, Provo, UT 84604-3380 | 2019-08-12 |
| 1861044604 | Kendra Staheli | Nurse Practitioner | 395 W Bulldog Blvd Ste 601, Provo, UT 84604-3331 | 2019-07-11 |
| Find all providers in PROVO | ||||
Please comment or provide details below to improve the information on SHIRLEY B ELLSWORTH.
| 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.