Individual
MS. KELLEY ANNE ELLSWORTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3301 NEW MEXICO AVE NW STE 205, WASHINGTON, DC 20016-3627
(202) 243-2500
Mailing address
3135 38TH ST NW, WASHINGTON, DC 20016-3726
(202) 744-4983
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA031761
DC
363A00000X
Physician Assistant
PA7445
MA
Other
Enumeration date
04/27/2019
Last updated
06/15/2022
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