Ellis, Nathanael

Ellis, Nathanael is an individual health care provider with primary practice located at 4900 Houston Rd , Florence KY 41042-4824. He recently has 3 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 / Family. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is his primary health care specialty. Ellis, Nathanael can be contacted via phone (859) 212-5441.

Contact Information

Primary practice address
4900 Houston Rd Florence KY 41042-4824
Fax:
Website:

Profile Details

NPI number 1932454055
LBN Legal business name Ellis, Nathanael
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 14th, 2012
Last updated Jul 19th, 2023 - 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 1932454055 NPPES
Kentucky MEDICAID 7100302330

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