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:
Health care specialties
Specialty | Code | License # | 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 2 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 | 1588866305 | NPPES |
Kentucky | MEDICAID | 7100026490 | |
Kentucky | MEDICAID | 200892820 |
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