Provider Demographics
NPI:1700056843
Name:ELLINGTON, JILLIAN MORGAN (NP)
Entity Type:Individual
Prefix:MS
First Name:JILLIAN
Middle Name:MORGAN
Last Name:ELLINGTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JILLIAN
Other - Middle Name:MORGAN
Other - Last Name:KOLSKY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:550 E STATE ROAD 434
Mailing Address - Street 2:
Mailing Address - City:LONGWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:32750-5222
Mailing Address - Country:US
Mailing Address - Phone:407-261-2917
Mailing Address - Fax:407-262-5718
Practice Address - Street 1:550 E STATE ROAD 434
Practice Address - Street 2:
Practice Address - City:LONGWOOD
Practice Address - State:FL
Practice Address - Zip Code:32750-5222
Practice Address - Country:US
Practice Address - Phone:407-261-2917
Practice Address - Fax:407-262-5718
Is Sole Proprietor?:No
Enumeration Date:2008-03-05
Last Update Date:2020-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9246924363LP0200X
GARN194621363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics