Ellis, Katie Jo
Ellis, Katie Jo is an individual health care provider with primary practice located at 730 W Market St , Lima OH 45801-4602. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Ellis, Katie Jo can be contacted via phone (419) 227-3361.Contact Information
Primary practice address
730 W Market St
Lima OH 45801-4602
Phone: (419) 227-3361
Fax: (419) 226-9826
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 50001778 | Ohio |
Profile Details
| NPI number | 1629017850 |
|---|---|
| LBN Legal business name | Ellis, Katie Jo |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 5th, 2006 |
| Last updated | Jan 25th, 2022 - about 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1629017850 | NPPES |
| Ohio | Other | P00126759 | MEDICARE RR |
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