Provider Demographics
NPI:1831781061
Name:MESHILEYA, ELLEN A (CRNP-PMH)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:A
Last Name:MESHILEYA
Suffix:
Gender:F
Credentials:CRNP-PMH
Other - Prefix:MS
Other - First Name:ELLEN
Other - Middle Name:ADEBISI
Other - Last Name:PINNOCK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:29831 BEACH AIR LANDING RD
Mailing Address - Street 2:
Mailing Address - City:DAGSBORO
Mailing Address - State:DE
Mailing Address - Zip Code:19939-5415
Mailing Address - Country:US
Mailing Address - Phone:301-538-5113
Mailing Address - Fax:
Practice Address - Street 1:24077 COUNTRY LIVING RD STE 2
Practice Address - Street 2:
Practice Address - City:MILLSBORO
Practice Address - State:DE
Practice Address - Zip Code:19966-3188
Practice Address - Country:US
Practice Address - Phone:302-224-1400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2023-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR191095363LP0808X
DEL8-0010412363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD119591300Medicaid