Individual provider · Type 1 NPI

Keith Lawrence Ellis

Pediatric Nurse Practitioner · Bridgeport, CT

NPI number 1144654666 Active

Practice location

46 Albion St
Bridgeport, CT 06605-2602

Fax (203) 330-6008

Other practice locations

  • 282 Washington St, Hartford, CT 06106-3322 · (860) 837-7250

Specialties and licenses

TaxonomyCodeLicense
Pediatric Nurse Practitioner Primary 363LP0200X5501 (CT)

Pediatric Nurse Practitioner: Definition to come...

74 other providers at this address

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About NPI 1144654666

Keith Lawrence Ellis's National Provider Identifier is 1144654666, issued on Sep 3, 2013. The primary taxonomy on file is Pediatric Nurse Practitioner (363LP0200X), and the practice location is in Bridgeport, CT. The record was last updated on Sep 12, 2022.