Hanisch, Ellen M
Hanisch, Ellen M is an individual health care provider with primary practice located at 11511 Canterwood Blvd Suite 45, Gig Harbor WA 98332-5813. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as her primary health care specialty. Hanisch, Ellen M can be contacted via phone (253) 858-4725.Contact Information
Primary practice address
11511 Canterwood Blvd Suite 45
Gig Harbor WA 98332-5813
Phone: (253) 858-4725
Fax: (253) 858-4452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | A-108210 | Iowa |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 110748 | Nebraska |
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | AP60134362 | Washington |
Profile Details
| NPI number | 1346248754 |
|---|---|
| LBN Legal business name | Hanisch, Ellen M |
| Credentials | NURSE PRACTITIONER |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 9th, 2005 |
| Last updated | Aug 1st, 2012 - about 12 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 | 1346248754 | NPPES |
| Iowa | Other | 33314 | WELLMARK |
| Iowa | MEDICAID | 0421586 | WELLMARK |
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