Individual
MRS. ELIZABETH ANNA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
2800 MAIN ST, BRIDGEPORT, CT 06606-4201
(203) 576-5152
Mailing address
38 HILLCREST AVE, DERBY, CT 06418-2213
(203) 767-2135
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
075812
CT
367500000X
Certified Registered Nurse Anesthetist
Primary
87818
CT
Other
Enumeration date
01/11/2012
Last updated
01/11/2012
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