Provider Demographics
NPI:1043520141
Name:MUMAW, ELLEN LEHMAN (WHNP)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:LEHMAN
Last Name:MUMAW
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:ELLEN
Other - Middle Name:BLAIR
Other - Last Name:STROUPE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:WHNP
Mailing Address - Street 1:635 KOSER DR
Mailing Address - Street 2:
Mailing Address - City:MARION
Mailing Address - State:AR
Mailing Address - Zip Code:72364-2671
Mailing Address - Country:US
Mailing Address - Phone:901-484-8648
Mailing Address - Fax:
Practice Address - Street 1:1660 BONNIE LN
Practice Address - Street 2:SUITE 105
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38016-0518
Practice Address - Country:US
Practice Address - Phone:901-888-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-07
Last Update Date:2023-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN0000015112363LW0102X
ARA03391 ANP363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health