Provider Demographics
NPI:1154690287
Name:GORRELL, ELLEN E (CNS)
Entity Type:Individual
Prefix:
First Name:ELLEN
Middle Name:E
Last Name:GORRELL
Suffix:
Gender:F
Credentials:CNS
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:168 E MARKET ST
Mailing Address - Street 2:PO BOX 3542
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44308-2038
Mailing Address - Country:US
Mailing Address - Phone:330-996-0347
Mailing Address - Fax:330-996-0359
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:STE 407
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-384-9001
Practice Address - Fax:330-384-9002
Is Sole Proprietor?:No
Enumeration Date:2011-12-19
Last Update Date:2013-11-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OHCOA.12679-NS364SA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SA2200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistAdult Health