Individual provider · Type 1 NPI

Mark Alan Ellett, AGACNP

Acute Care Nurse Practitioner · Idaho Falls, ID

NPI number 1295402089 Active

Practice location

3100 Channing Way
Idaho Falls, ID 83404-7533

Mailing address

3817 Nora St
Pocatello, ID 83204-2023

Other practice locations

  • 3817 Nora St, Pocatello, ID 83204-2023 · (208) 604-1715

Specialties and licenses

TaxonomyCodeLicense
Critical Care Medicine Registered Nurse 163WC0200X45067 (ID)
Acute Care Nurse Practitioner Primary 363LA2100X69540 (ID)

Acute Care Nurse Practitioner: Definition to come...

240 other providers at this address

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About NPI 1295402089

Mark Alan Ellett, AGACNP's National Provider Identifier is 1295402089, issued on Aug 27, 2021. The primary taxonomy on file is Acute Care Nurse Practitioner (363LA2100X), and the practice location is in Idaho Falls, ID. The record was last updated on Aug 30, 2021.