Mary Ellen Ehman, FNP
Individual provider Active NPI Family Nurse Practitioner · Morro Bay, CA
NPI 1255404265 · NPPES record last updated Mar 12, 2014
Key facts
- NPI
- 1255404265
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 10487 (CA)
- Practice address
- 1405 Teresa Drive
Morro Bay, CA 93442 - Phone
- (805) 772-2237
- Fax
- (805) 772-2536
- NPI assigned
- Nov 16, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8167 | TN | MD | Physical Therapist |
| 10487 | CA | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Diverse Medical Management, Inc. | Past |
Accepting new patients | |
| Pathways Health Management Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8167 | TN | |
| Family Nurse Practitioner | 363LF0000X | 10487 | CA | Yes |
Addresses
Primary practice location
1405 Teresa Drive
Morro Bay, CA 93442
Mailing address
355 Las Vegas
Morro Bay, CA 93442
Phone (805) 772-7100
Other names
- Mrs. Mary Ellen Ehman-Faust
Other providers in Morro Bay, CA
- Diversified Intervention Group
- Richard Lincoln Donald V
- Natalia Donici
- Deborah Ilealoha Dover
- Ross J. Dover
- Elite Eyecare Medical Group a Medical Corporation
- Elite Eyecare Medical Group a Medical Corporation
- Christopher L Ellis
- Emily Elrod-Black
- Clara Erickson
All providers in Morro Bay, CA · Family Nurse Practitioner in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 12, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.