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Individual
ELLEN A LINK
Active
Individual
ELLEN A LINK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
27612
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0024000
—
IA
01
—
02400
WELLMARK BCBS
IA
Enumeration date
09/27/2005
Last updated
09/28/2007
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