Phyllis Jean Ellena, ADVANCED PRACTICE RN

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

439625 Issued in TX

Practice address

4026 Parkway Dr
San Antonio, TX 78228-2311

Phone

(210) 219-5135

Fax

(210) 434-7039

NPI assigned

Mar 6, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1740450642",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4026 PARKWAY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782282311",
            "telephone_number": "210-219-5135",
            "fax_number": "210-434-7039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4026 PARKWAY DR",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782282311",
            "telephone_number": "210-219-5135",
            "fax_number": "210-434-7039"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLENA",
        "first_name": "PHYLLIS",
        "middle_name": "JEAN",
        "name_prefix": "Ms.",
        "credential": "ADVANCED PRACTICE RN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "TX",
            "license": "439625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Naga Pranavi Ellanti, MD
• James B Elledge, OD, MBA, FAAO
• Richard Elledge, MD
• Ellen Boyle Duncan PLLC
• Ellen W Lin MD PA
• Leslie Ann Ellenbogen, L.C.S.W.-A.C.P.
• Mary Eller, M.S., CCC-SLP
• Sonja Kristina Ellerbee, MSN, APRN, NP-C
• Jan Rochelle Elleson, M.A., CCC-SLP
• Gaylord Elling, D.D.S

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in San Antonio, TX
• Providers in San Antonio, TX by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.