Ellis, Carlie G.

Ellis, Carlie G. is an individual health care provider with primary practice located at 2709 Hemlock St , Bremerton WA 98310-2623. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Ellis, Carlie G. can be contacted via phone (360) 373-2547.

Contact Information

Primary practice address
2709 Hemlock St Bremerton WA 98310-2623
Phone: (360) 373-2547
Fax: (360) 479-8268
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP60971061 Washington
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X AP60971061 Washington

Profile Details

NPI number 1750933040
LBN Legal business name Ellis, Carlie G.
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 16th, 2019
Last updated Nov 3rd, 2020 - 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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Identifiers

StateTypeNumberIssuer
All States NPI 1750933040 NPPES
Washington MEDICAID 2138383

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