Ellett, Mark Alan

Ellett, Mark Alan is an individual health care provider with primary practice located at 3100 Channing Way , Idaho Falls ID 83404-7533. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Ellett, Mark Alan can be contacted via phone (208) 604-1715.

Contact Information

Primary practice address
3100 Channing Way Idaho Falls ID 83404-7533
Phone: (208) 604-1715
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Critical Care Medicine 163WC0200X 45067 Idaho
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 69540 Idaho

Profile Details

NPI number 1295402089
LBN Legal business name Ellett, Mark Alan
Credentials AGACNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 27th, 2021
Last updated Aug 30th, 2021 - about 4 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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