Individual
ELLYN ALLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5255 E STOP 11 RD STE 200, INDIANAPOLIS, IN 46237-6341
(317) 528-1212
Mailing address
PO BOX 781076, DETROIT, MI 48278-1076
(317) 528-4800
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
NA
IN
363A00000X
Physician Assistant
Primary
10004323A
IN
Other
Enumeration date
01/10/2024
Last updated
03/27/2024
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