Ellsworth, Bettina Marie

Ellsworth, Bettina Marie is an individual health care provider with primary practice located at 993 Long Ln , Gettysburg PA 17325-2920. She recently has only one registered license in Allopathic & Osteopathic Physicians / Obstetrics, which is considered as her primary health care specialty. Ellsworth, Bettina Marie can be contacted via phone (717) 334-6068.

Contact Information

Primary practice address
993 Long Ln Gettysburg PA 17325-2920
Phone: (717) 334-6068
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X MD027671E Pennsylvania

Profile Details

NPI number 1336178615
LBN Legal business name Ellsworth, Bettina Marie
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 30th, 2006
Last updated Dec 5th, 2012 - about 14 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 1336178615 NPPES
Pennsylvania MEDICAID 000876100
Pennsylvania Other 104609
Pennsylvania Other 4244528
Pennsylvania Other 150863
Pennsylvania MEDICAID 132151001
Pennsylvania Other 38221

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