Ellis, Misty D

Ellis, Misty D is an individual health care provider with primary practice located at 231 E Chestnut St , Louisville KY 40202-1821. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is her primary health care specialty. Ellis, Misty D can be contacted via phone (502) 629-6000.

Contact Information

Primary practice address
231 E Chestnut St Louisville KY 40202-1821
Phone: (502) 629-6000
Fax: (502) 629-5865
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 3005293 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 3005293 Kentucky

Profile Details

NPI number 1588866305
LBN Legal business name Ellis, Misty D
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 4th, 2007
Last updated Jul 21st, 2023 - about last year

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 1588866305 NPPES
Kentucky MEDICAID 7100026490
Kentucky MEDICAID 200892820

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