Individual
ELLIE RENEE DUCKWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2230 S SPRINGFIELD AVE STE H-J, BOLIVAR, MO 65613-9133
(417) 777-4800
Mailing address
4372 W MADISON ST, SPRINGFIELD, MO 65802-4979
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2026005847
MO
Other
Enumeration date
02/06/2026
Last updated
02/06/2026
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