Provider Demographics
NPI:1780331918
Name:DAVIS, ELLYN KATHRYN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:ELLYN
Middle Name:KATHRYN
Last Name:DAVIS
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
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Mailing Address - Street 1:6480 HARRISON AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247-7961
Mailing Address - Country:US
Mailing Address - Phone:513-354-3700
Mailing Address - Fax:
Practice Address - Street 1:8099 CORNELL RD STE 100
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45249-2231
Practice Address - Country:US
Practice Address - Phone:513-354-3700
Practice Address - Fax:513-793-1019
Is Sole Proprietor?:No
Enumeration Date:2022-03-08
Last Update Date:2023-02-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant