Individual
CLAIRE E ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
4101 TECHNOLOGY AVE, NEW ALBANY, IN 47150-8548
(812) 590-3334
Mailing address
PO BOX 950248, LOUISVILLE, KY 40295-0248
(812) 949-5482
(812) 949-5966
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71005890A
IN
363LF0000X
Family Nurse Practitioner
3009301
KY
363LF0000X
Family Nurse Practitioner
71005890A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201361760
—
IN
05
—
7100374130
—
KY
Enumeration date
04/20/2015
Last updated
02/24/2023
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