Ellis, Carol A

Ellis, Carol A is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Ellis, Carol A can be contacted via phone (208) 746-1383.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 746-1383
Fax: (208) 746-6348
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X NP-825A Idaho
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X AP30007996 Washington

Profile Details

NPI number 1194919647
LBN Legal business name Ellis, Carol A
Credentials NPC
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 28th, 2007
Last updated Mar 8th, 2016 - about 9 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 1194919647 NPPES
Idaho Other 807875800 HEATHLY CONNECTIONS
Idaho Other 1341036 HEATHLY CONNECTIONS
Idaho MEDICAID 807875800 HEATHLY CONNECTIONS
Idaho Other NPZA5 HEATHLY CONNECTIONS
Idaho Other 000010005325 HEATHLY CONNECTIONS
Idaho Other 0226013 HEATHLY CONNECTIONS
Idaho MEDICAID 9654294 HEATHLY CONNECTIONS

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