Provider Demographics
NPI:1518792621
Name:LLOYD, ELLEN MARIE (APRN)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARIE
Last Name:LLOYD
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6120 S YALE AVE STE 1210
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74136-4234
Mailing Address - Country:US
Mailing Address - Phone:918-888-5211
Mailing Address - Fax:918-888-5270
Practice Address - Street 1:6120 S YALE AVE STE 1210
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74136-4234
Practice Address - Country:US
Practice Address - Phone:918-888-5211
Practice Address - Fax:918-888-5270
Is Sole Proprietor?:No
Enumeration Date:2024-09-06
Last Update Date:2024-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK219627363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care