Individual
ELIZABETH ELLENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1542 TULANE AVE # T4M2, NEW ORLEANS, LA 70112-2865
(504) 568-2713
Mailing address
1514 JEFFERSON HWY, NEW ORLEANS, LA 70121-2429
(504) 842-4000
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
302220
LA
207RH0003X
Hematology & Oncology Physician
Primary
302220
LA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06789778
—
MS
05
—
2334174
—
LA
Enumeration date
03/20/2013
Last updated
07/21/2022
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