DR. JENNIFER J. ELLISON (NPI# 1326304981) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1326304981 |
| Entity Type | Individual |
| Full Name | DR. JENNIFER J. ELLISON |
| Credential | PHARM.D. |
| Practice Address |
3015 Tower Ave Superior WI 54880-5324 |
| Mailing Address |
37 Nynas Rd Esko MN 55733-9734 |
| Practice Telephone | 7153945551 |
| Mailing Telephone | 6122814787 |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2012-04-09 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 16203-40 | WI | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 120060 | MN | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730648700 | Jennifer Ellison | Speech-Language Pathologist | 2206 W 167th St, Markham, IL 60428-5607 | 2019-03-18 |
| 1356651954 | Jennifer Natasha Rose Ellison | Nurse Practitioner | 377 W Campbell Rd Ste 100, Richardson, TX 75080-3695 | 2010-10-15 |
| 1588139778 | Jennifer Briggs Ellison | Counselor | 77 E 1st St, Corning, NY 14830-2715 | 2018-10-04 |
| 1669927984 | Jennifer Ellison | Nurse Practitioner | 3132 Old Jacksonville Rd, Springfield, IL 62704-7400 | 2016-08-16 |
| Street Address |
3015 TOWER AVE |
| City | SUPERIOR |
| State | WI |
| Zip Code | 54880-5324 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053731521 | Nicholas Fetter | Pharmacist | 3015 Tower Ave, Superior, WI 54880-5324 | 2014-04-23 |
| 1235160375 | K Mart Corp | Pharmacy | 3015 Tower Ave, Superior, WI 54880-5324 | 2006-07-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104427194 | Alana Catherine Sullivan | Speech-Language Pathologist | 25 N 25th Street E, Superior, WI 54880 | 2020-11-05 |
| 1710524970 | Sean Wiberg Peterson | Specialist/Technologist | 1810 Catlin Ave, Room 1246, Superior, WI 54880 | 2019-12-06 |
| 1558858936 | Brent Adam Engstrom | Student in an Organized Health Care Education/Training Program | 1410 Nth 23rd Street, Superior, WI 54880 | 2018-04-20 |
| 1558769125 | David Kroll | Specialist | Balknap & Catlin Aves., Superior, WI 54880 | 2014-12-15 |
| 1154670321 | Superior Treatment Center, Inc | Community/Behavioral Health | 1507 Tower Ave Ste 307, Superior, WI 54880 | 2012-09-04 |
| 1548551658 | Dionne Jeannine Corcoran | Midwife | 916 Hammond Ave Ste 222, Superior, WI 54880 | 2011-04-22 |
| 1821235433 | Lauren Ashley Miller | Speech-Language Pathologist | 35 N. 28th Street, Superior, WI 54880 | 2009-01-20 |
| 1528261989 | Stacy Ann Kennelly | Physical Therapist | 1612 N 37th Street, Superior, WI 54880 | 2007-06-06 |
| 1760564942 | James Henry Dobis | Family Medicine | 3520 Tower Avenue, Twin Ports Va Outpatient Clinic, Superior, WI 54880 | 2006-10-19 |
| 1134214398 | Kevin M Mikel | Dentist | 3312 Tower Avenue, Superior, WI 54880 | 2006-10-04 |
| Find all providers in zip 54880 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255990354 | Kenzie Hohman | Pharmacist | 3500 Tower Ave Ste B, Superior, WI 54880-4685 | 2019-06-12 |
| 1144720319 | Michael Joseph Hillmeyer | Pharmacist | 3500 Tower Ave Ste C, Superior, WI 54880-4685 | 2018-02-14 |
| 1548635659 | Christopher Perkins | Pharmacist | 1995 E Coalton Rd Apt 4-101, Superior, CO 80027-4465 | 2015-12-01 |
| 1831521822 | Susan Jane Seward | Pharmacist | 2031 Dailey Ln, Superior, CO 80027-8106 | 2013-08-01 |
| 1538435078 | Renee Marie Toner | Pharmacist | 1601 Coalton Road, Superior, CO 80027 | 2012-03-29 |
| 1083981187 | Cara Bufkin | Pharmacist | 773 Maroon Peak Cir, Superior, CO 80027-6103 | 2011-11-17 |
| 1932419470 | Mi-sook Lee | Pharmacist | 2300 Andrew Dr, Superior, CO 80027 | 2010-10-18 |
| 1821309758 | Gary Tibbett Woodson | Pharmacist | 22 Lozeau Ln, Superior, MT 59872-9622 | 2010-06-25 |
| 1396068490 | Richard Donald Moe | Pharmacist | 2631 Tower Ave, Superior, WI 54880-4846 | 2010-03-04 |
| 1073111803 | Kathy Gore | Pharmacist | 3705 Tower Ave, Superior, WI 54880-5338 | 2020-10-14 |
| Find all providers in SUPERIOR | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.