Ellis, Constance Colettle

Ellis, Constance Colettle is an sole proprietor health care provider with primary practice located at 9245 Wallace Lake Rd Ste A , Shreveport LA 71106. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Case Manager/Care Coordinator, Other Service Providers / Community Health Worker. Other Service Providers / Community Health Worker is her primary health care specialty. Ellis, Constance Colettle can be contacted via phone (318) 221-2828.

Contact Information

Primary practice address
9245 Wallace Lake Rd Ste A Shreveport LA 71106
Phone: (318) 221-2828
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Case Manager/Care Coordinator 171M00000X
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1104337856
LBN Legal business name Ellis, Constance Colettle
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 21st, 2017
Last updated May 17th, 2018 - about 7 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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