Sharetta Ellison, GRADUATE NURSE

Primary specialty

TechnicianTaxonomy code 374700000X

License

21075973 Issued in TX

Practice address

2525 E Lake Shore Dr Apt 608
Waco, TX 76705-7804

Phone

(254) 732-2712

NPI assigned

Apr 25, 2008

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

State licenses

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

{
    "created_epoch": "1209081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1209081600000",
    "number": "1992970305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2525 E LAKE SHORE DR APT 608",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767057804",
            "telephone_number": "254-732-2712"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2525 E LAKE SHORE DR APT 608",
            "city": "WACO",
            "state": "TX",
            "postal_code": "767057804",
            "telephone_number": "254-732-2712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "SHARETTA",
        "name_prefix": "Miss",
        "credential": "GRADUATE NURSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-04-25",
        "last_updated": "2008-04-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": "TX",
            "license": "21075973",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy Coyle Elliott, PA
• Cassidy Ellis, OT
• Jon Michael Ellis, M.D.
• Keith Taylor Ellison, M.D.
• Lashae Ellison, BT
• Abbey Elliston, M.S. CCC-SLP
• Janet R Ellor, FNP
• Ashleigh Elmshaeuser
• Kimberly Elmshaeuser, FNP-C
• Steven M Elwell, MD

• Technician in Waco, TX
• Providers in Waco, TX by specialty
• Technician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 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.