Individual
KAREN L. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, ANP-C
Contact information
Practice address
810 HOSPITAL DR STE 200, BEAUMONT, TX 77701-4654
(409) 212-5512
(409) 212-5898
Mailing address
36 SANDELWOOD TRL, BEAUMONT, TX 77706-7855
(409) 651-2676
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
AP110025
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147715001
—
TX
01
—
8N8667
BLUE CROSS & BLUE SHIELD
TX
Enumeration date
08/09/2006
Last updated
03/30/2022
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