Ellington, Judith M

Ellington, Judith M is an individual health care provider with primary practice located at 530 Wi Dells Pkwy S , Lake Delton WI 53940-0390. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Ellington, Judith M can be contacted via phone (608) 254-5400.

Contact Information

Primary practice address
530 Wi Dells Pkwy S Lake Delton WI 53940-0390
Phone: (608) 254-5400
Fax: (608) 253-8585
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 49722-030 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 49722 Wisconsin

Profile Details

NPI number 1720044035
LBN Legal business name Ellington, Judith M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 25th, 2006
Last updated Jan 21st, 2016 - about 10 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 1720044035 NPPES
Wisconsin MEDICAID 1720044035

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