Godfrey, Ellen T.
Godfrey, Ellen T. is an individual health care provider with primary practice located at 44084 Riverside Parkway, Suite 300 , Leesburg VA 20176-5102. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Godfrey, Ellen T. can be contacted via phone (703) 724-7530.Contact Information
Primary practice address
44084 Riverside Parkway, Suite 300
Leesburg VA 20176-5102
Phone: (703) 724-7530
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | 0110-004631 | Virginia |
Profile Details
| NPI number | 1437564911 |
|---|---|
| LBN Legal business name | Godfrey, Ellen T. |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 24th, 2014 |
| Last updated | Oct 18th, 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1437564911 | NPPES |
| Virginia | MEDICAID | 30016466390003 | |
| Virginia | MEDICAID | 1437564911 |
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