Organization
PEDIATRIC HEALTH CONNECT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHAUNTELLE ELLIS MSN, CRNP, CPNP-PC (NURSE PRACTITIONER)
(301) 467-5033
Entity
Organization
Contact information
Practice address
1302 CRONSON BLVD STE J, CROFTON, MD 21114-2064
(301) 467-5033
Mailing address
2421 VINEYARD LN, CROFTON, MD 21114-1138
(301) 467-5033
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
—
—
363LP0200X
Pediatric Nurse Practitioner
Primary
—
—
Other
Enumeration date
08/12/2025
Last updated
08/12/2025
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