Individual
PEGGY B ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
211 4TH ST, ALEXANDRIA, LA 71301-8421
(318) 473-3000
Mailing address
211 4TH ST, BOX 30135, ALEXANDRIA, LA 71301-8421
(318) 448-4440
(318) 473-4340
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN048880
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1919691
—
LA
Enumeration date
08/26/2005
Last updated
10/17/2007
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