Lacey Ellyson, NP-C

Individual provider Active NPI Family Nurse Practitioner · Lisbon, OH

NPI 1659868644 · NPPES record last updated Mar 4, 2021

Key facts

NPI
1659868644
Entity type
Individual (NPI type 1)
Primary specialty
Family Nurse Practitioner 363LF0000X
License
APRN.CNP.022504 (OH)
Practice address
400 N Market St
Lisbon, OH 44432-1146
Phone
(330) 424-9866
NPI assigned
Apr 16, 2018
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Certified Nurse Practitioner

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X APRN.CNP.022504 OH Yes

Addresses

Primary practice location

400 N Market St
Lisbon, OH 44432-1146

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 424-9866

Other names

  • Lacey Glover Former name

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address lellyson53350@direct.chmca.org Direct
Direct Messaging Address lellyson53350@direct.chmca.org

Other providers in Lisbon, OH

All providers in Lisbon, OH · Family Nurse Practitioner in Ohio

Sources for this page

Verify at the official NPI Registry.