Individual
CAROL A ELLIS
Active
Individual
CAROL A ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NPC
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30007996
WA
363LA2200X
Adult Health Nurse Practitioner
Primary
NP-825A
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010005325
REGENCE BLUESHIELD
ID
01
—
0226013
LABOR & INDUSTRIES
WA
01
—
1341036
DMERC
—
01
—
807875800
HEATHLY CONNECTIONS
ID
05
—
807875800
—
ID
05
—
9654294
—
WA
01
—
NPZA5
BLUE CROSS
ID
Enumeration date
08/28/2007
Last updated
03/08/2016
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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