Individual
ABIGAIL P ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1703 INNOVATION DR STE 4120, YORK, PA 17408-8815
(717) 849-5576
(717) 849-5596
Mailing address
1703 INNOVATION DR STE 4120, YORK, PA 17408-8815
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
0110006891
VA
363A00000X
Physician Assistant
MA065545
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1902457385
—
VA
05
—
30016153700001
—
VA
Enumeration date
09/26/2019
Last updated
02/25/2025
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