Most Relevant Information
Provider Data
| NPI Number: | 1003238668 |
| Provider Name: | ELLEN EDITH MOUSER PMHNP |
| Entity Type: | Individual |
| Taxonomy Code: | 363LP0808X |
| Specialty: | Nurse Practitioner |
| License Number: | 209011105 |
Most Important Dates
| Enumeration Date: | 01/15/2014 |
| Last Updated: | 03/07/2023 |
Provider Practice Location
270 MAPLE SUMMIT RD
JERSEYVILLE
IL
62052
Practice Location Phone/Fax
| Phone: | 6186399952 |
| Fax: | 6186399955 |
Provider Mailing Location
700 S J ST
LAKEVIEW
OR
976301623
Provider Mailing Phone/Fax
| Phone: | 5419473366 |
| Fax: | 5419474404 |