Ellen Ray, | |
4525 Mid Rivers Mall Dr Ste 10, Cottleville, MO 63376-2820 | |
(636) 229-3350 | |
Not Available |
Full Name | Ellen Ray |
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Gender | Female |
Speciality | Nurse Practitioner - Pediatrics |
Location | 4525 Mid Rivers Mall Dr Ste 10, Cottleville, Missouri |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1932880333 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
163WE0003X | Registered Nurse - Emergency | 2005005840 (Missouri) | Secondary |
363LP0200X | Nurse Practitioner - Pediatrics | 2023033858 (Missouri) | Primary |
Entity Name | Mercy Clinic East Communities |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1851335228 PECOS PAC ID: 7214827922 Enrollment ID: O20070521000006 |
Entity Name | Mercy Clinic Ent Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1366705998 PECOS PAC ID: 7517118813 Enrollment ID: O20121114000539 |
Mailing Address | Practice Location Address |
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Ellen Ray, Po Box 776084, Chicago, IL 60677-6442 Ph: (636) 229-3350 | Ellen Ray, 4525 Mid Rivers Mall Dr Ste 10, Cottleville, MO 63376-2820 Ph: (636) 229-3350 |
Neelima Nalluri, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 133 Shortleaf Pine Dr, Cottleville, MO 63304 Phone: 314-741-0911 | |
Corrie Beth Hitzelberger, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1309 Commons Cir, Cottleville, MO 63304 Phone: 816-284-9650 | |
Ayia Abdeljabbar, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 5055 Highway N Ste 102, Cottleville, MO 63304 Phone: 636-244-0247 | |
Carley Hall, AGNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 5230 Highway N, Cottleville, MO 63304 Phone: 636-675-7991 |