Individual
MRS. RITA ANN ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3676 PARKER BLVD, PUEBLO, CO 81008-2212
(719) 553-2200
(719) 553-2216
Mailing address
PO BOX 9000, PUEBLO, CO 81008-9000
(719) 553-1802
(719) 553-2216
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
23208
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01232081
—
CO
Enumeration date
03/22/2006
Last updated
07/08/2007
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