Individual provider · Type 1 NPI

Kathryn Louise Ellens, NP

Gerontology Nurse Practitioner · Grand Rapids, MI

NPI number 1154819035 Active

Practice location

4100 Lake Dr SE Ste 200
Grand Rapids, MI 49546-8292

Call (616) 391-3759 Map

Mailing address

100 Michigan St NE # MC845
Grand Rapids, MI 49503-2560

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	4704278582 (MI)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1154819035

Kathryn Louise Ellens, NP's National Provider Identifier is 1154819035, issued on Apr 26, 2018. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Grand Rapids, MI. The record was last updated on Mar 27, 2023.