Ellis, Teresa W

Ellis, Teresa W is an individual health care provider with primary practice located at 227 Falcon Dr Ste 104 , Mt Sterling KY 40353-9792. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Acute Care, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ellis, Teresa W can be contacted via phone (859) 497-5459.

Contact Information

Primary practice address
227 Falcon Dr Ste 104 Mt Sterling KY 40353-9792
Phone: (859) 497-5459
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 3007458 Kentucky
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024087401 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 3007458 Kentucky

Profile Details

NPI number 1619948569
LBN Legal business name Ellis, Teresa W
Credentials Advanced Practice Registered Nurse (APRN)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 30th, 2006
Last updated Oct 19th, 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 1619948569 NPPES
Kentucky MEDICAID 7100007360

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