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Individual
CORWIN RYAN ELLSWORTH
Active
Individual
CORWIN RYAN ELLSWORTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2609
AZ
363A00000X
Physician Assistant
Primary
PA-1575
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20038569
—
ID
05
—
779548
—
AZ
Enumeration date
08/20/2009
Last updated
03/23/2026
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