Ellsworth, Erin

Ellsworth, Erin is an individual health care provider with primary practice located at 10400 75Th St , Kenosha WI 53142-7884. 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 / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Ellsworth, Erin can be contacted via phone (262) 948-5600.

Contact Information

Primary practice address
10400 75Th St Kenosha WI 53142-7884
Phone: (262) 948-5600
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Acute Care 363LA2100X 7152-33 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 7152-033 Wisconsin

Profile Details

NPI number 1902359250
LBN Legal business name Ellsworth, Erin
Credentials APNP
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 3rd, 2016
Last updated Feb 22nd, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902359250 NPPES
Wisconsin MEDICAID 100060908

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