Individual provider · Type 1 NPI
Kathleen Dunlevy Ellis, PA-C
Surgical Physician Assistant · Mishawaka, IN
NPI number
1891570545
Active
Practice location
611 E Douglas Rd Ste 207
Mishawaka, IN 46545-1465
Mailing address
5215 Holy Cross Pkwy
Mishawaka, IN 46545-1469
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Surgical Physician Assistant Primary | 363AS0400X | 10004107A (IN) |
Surgical Physician Assistant: Definition to come...
3 other providers at this address
About NPI 1891570545
Kathleen Dunlevy Ellis, PA-C's National Provider Identifier is 1891570545, issued on Aug 30, 2023. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Mishawaka, IN. The record was last updated on Jan 13, 2026.