Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Jared Michael Ellis, LPN

Individual provider Licensed Practical Nurse · NPI 1336077205

Jared Michael Ellis, LPN is a Licensed Practical Nurse in Charlotte, North Carolina. Licensed in South Carolina. Registered with an NPI since 2026.

Licensed in
SC
In the registry since
2026
What do these letters mean?
LPN — Licensed Practical Nurse
A licensed nurse who works under the direction of an RN or physician.

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Practice location Address checks out

10660 Park Rd Ste 3400
Charlotte, NC 28210-8461
Phone: (704) 667-3840
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Licensed Practical Nurse (primary) Taxonomy 164W00000X · Licence 57164 (SC)

Record details

NPI number1336077205
Entity typeIndividual (Type 1)
GenderMale
Credentials LPN
Sole proprietorNo
NPI enumeratedMay 11, 2026
Last updated in NPPESMay 11, 2026
Certification dateMay 11, 2026

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