Mary Jean Ellsworth, RN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

155127 Issued in CA

Practice address

2325 W Main St
Visalia, CA 93291-4599

Phone

(559) 624-1097

Fax

(559) 624-1086

NPI assigned

Nov 13, 2007

Sex

Female

Sole proprietor

No

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)

Not enrolled

Credentials

Registered Nurse

State licenses

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

{
    "created_epoch": "1194912000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247011200000",
    "number": "1922288380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 CAMPUS DR",
            "city": "HANFORD",
            "state": "CA",
            "postal_code": "932304375",
            "telephone_number": "559-582-3211",
            "fax_number": "559-584-5672"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2325 W MAIN ST",
            "city": "VISALIA",
            "state": "CA",
            "postal_code": "932914599",
            "telephone_number": "559-624-1097",
            "fax_number": "559-624-1086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLSWORTH",
        "first_name": "MARY",
        "middle_name": "JEAN",
        "name_prefix": "Mrs.",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-11-13",
        "last_updated": "2009-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "CA",
            "license": "155127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer K Elliott, DPT
• Betsy Donalyn Ellis
• Desta Ellis, M.D.
• Rosalie Ellis
• Tyler J. Ellis, MD
• Jennifer Elmer, DDS
• Ata Elmi
• Bradley Charles Ely, FNP-C
• Reza John Emami, MD
• Melissa Emerson

• Registered Nurse in Visalia, CA
• Providers in Visalia, CA by specialty
• Registered Nurse in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2009; 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.