Provider Demographics
NPI:1114499845
Name:ELLZEY, ASHLEY NICHOLE
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:NICHOLE
Last Name:ELLZEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:928 12TH ST
Mailing Address - Street 2:
Mailing Address - City:GREELEY
Mailing Address - State:CO
Mailing Address - Zip Code:80631-4024
Mailing Address - Country:US
Mailing Address - Phone:970-347-1330
Mailing Address - Fax:
Practice Address - Street 1:928 12TH ST
Practice Address - Street 2:
Practice Address - City:GREELEY
Practice Address - State:CO
Practice Address - Zip Code:80631-4024
Practice Address - Country:US
Practice Address - Phone:970-347-1330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-12-19
Last Update Date:2018-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care
No376K00000XNursing Service Related ProvidersNurse's Aide