Lisa Marie Ellsworth, RN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN9525412 Issued in FL

Practice address

3335 Pacific Dr
Naples, FL 34119-8665

Phone

(425) 985-0506

NPI assigned

Mar 27, 2023

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1679875200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679875200000",
    "number": "1043913080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3335 PACIFIC DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198665",
            "telephone_number": "425-985-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3335 PACIFIC DR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "341198665",
            "telephone_number": "425-985-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-27",
        "last_updated": "2023-03-27",
        "certification_date": "2023-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WN1003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Nutrition Support",
            "state": "FL",
            "license": "RN9525412",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "RN9525412",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Darlene Elliott, M.D.
• Tunisia Ellis Penta
• Candace Ellis, O.D.
• Christopher S Ellis, PT, DPT
• Emily Michelle Ellis, ARNP
• Hany Medhat Badie Mohamed Elmahdy, M.D.
• Eloquent Eyes LLC
• Wanda Elozegui Alfonso, M.D
• Elsa Espinosa Page
• Zachary Michael Elstad, M.D.

• Registered Nurse in Naples, FL
• Providers in Naples, FL by specialty
• Registered Nurse in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.