Individual
ANDREW MICHAEL ELLENWOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP-C
Contact information
Practice address
11594 WHISTLE DR, FISHERS, IN 46037-0054
(317) 706-7246
(317) 706-3417
Mailing address
29943 NETWORK PL, CHICAGO, IL 60673-1299
(317) 706-3415
(317) 706-7246
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005903A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201330710
—
IN
Enumeration date
09/27/2015
Last updated
11/18/2025
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