Bivens, Ellen

Bivens, Ellen is an individual health care provider with primary practice located at 312 N Kentucky St , West Plains MO 65775-2073. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Bivens, Ellen can be contacted via phone (417) 257-7076.

Contact Information

Primary practice address
312 N Kentucky St West Plains MO 65775-2073
Phone: (417) 257-7076
Fax: (417) 257-1417
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 120310 Missouri

Profile Details

NPI number 1447257324
LBN Legal business name Bivens, Ellen
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 7th, 2005
Last updated Nov 1st, 2011 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447257324 NPPES
Missouri MEDICAID 202169405

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