Provider Demographics
NPI:1164839643
Name:LAYTON, ELLEN MARY (APRN, FNP-BC)
Entity type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:MARY
Last Name:LAYTON
Suffix:
Gender:F
Credentials:APRN, FNP-BC
Other - Prefix:MRS
Other - First Name:ELLEN
Other - Middle Name:LAYTON
Other - Last Name:MULLARKEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN, FNP-BC
Mailing Address - Street 1:801 W IDLEWILD AVE
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33604
Mailing Address - Country:US
Mailing Address - Phone:813-521-0958
Mailing Address - Fax:727-867-6795
Practice Address - Street 1:DR. TRACI'S HOUSE
Practice Address - Street 2:904 E HENRY AVE
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33604
Practice Address - Country:US
Practice Address - Phone:813-510-5105
Practice Address - Fax:727-867-6795
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-17
Last Update Date:2025-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9307092363L00000X
FLAPRN9307092363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL013390200Medicaid