Nina S Ellison, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN1563 Issued in SC

Practice address

1008 Lake Murray Blvd
Irmo, SC 29063-2821

Phone

(612) 225-1512

Fax

(612) 234-4625

NPI assigned

Oct 2, 2006

Last updated

Jun 11, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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)

Enrolled

State licenses

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1244678400000",
    "number": "1952494916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 2ND AVE S",
            "address_2": "SUITE 400",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554023318",
            "telephone_number": "612-225-1512",
            "fax_number": "612-234-4625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1008 LAKE MURRAY BLVD",
            "city": "IRMO",
            "state": "SC",
            "postal_code": "290632821",
            "telephone_number": "612-225-1512",
            "fax_number": "612-234-4625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "NINA",
        "middle_name": "S",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-02",
        "last_updated": "2009-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "SC",
            "license": "APRN1563",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NC",
            "license": "5004353",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Nurse Practitioner in Irmo, SC
• Providers in Irmo, SC by specialty
• Family Nurse Practitioner in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 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.