Keith L Ellis
Nurse Practitioner, Pediatrics in Bridgeport, Connecticut
1144654666- Practice location
- 46 Albion St, Bridgeport, CT 06605-2602
- Phone
- 203-330-6000
- Fax
- 203-330-6008
- Last updated
- September 12, 2022
Keith Lawrence Ellis is a Nurse Practitioner, Pediatrics based in Bridgeport, CT. Keith Lawrence Ellis practices in Bridgeport, CT. The NPI Number for Keith Lawrence Ellis is 1144654666 and holds a License No. 5501 (CT). The current practice location address for Keith Lawrence Ellis is 46 Albion St, Bridgeport, CT 06605-2602 and can be reached out via phone at 203-330-6000 and via fax at 203-330-6008.
Provider Profile Details
- NPI Number
- 1144654666
- Provider Name
- Keith Lawrence Ellis
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 46 Albion St, Bridgeport, CT 06605-2602
- Phone Number
- 203-330-6000
- Fax Number
- 203-330-6008
- Primary Taxonomy
- Nurse Practitioner, Pediatrics · 363LP0200X
- Sole Proprietor
- No
- Provider Enumeration Date
- September 3, 2013
- Last Update Date
- September 12, 2022
- Certification Date
- September 12, 2022
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 46 Albion St
Bridgeport, CT 06605-2602 - City
- Bridgeport
- State
- Connecticut
- Zip
- 06605-2602
- Phone Number
- 203-330-6000
- Fax Number
- 203-330-6008
Provider Business Mailing Address Details
- Address
- 46 Albion St
Bridgeport, CT 06605-2602 - City
- Bridgeport
- State
- CT
- Zip
- 06605-2602
- Phone Number
- 203-330-6000
- Fax Number
- 203-330-6008
License Information
- License Number
- 5501
- License State
- CT
- Taxonomy
- Nurse Practitioner, Pediatrics · 363LP0200X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Nurse Practitioner, Pediatrics providers near Bridgeport, CT
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- Carolyn Walsh, CPNPNurse Practitioner, Pediatrics · NPI 1730598947
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Frequently Asked Questions
What is the NPI number of Keith L Ellis?
The NPI number of Keith L Ellis is 1144654666. It was assigned on September 3, 2013 and is currently active in the NPPES registry.
What is the specialty of Keith L Ellis?
Keith L Ellis is registered under the primary taxonomy Nurse Practitioner, Pediatrics (code 363LP0200X), licensed in CT under license number 5501.
Where does Keith L Ellis practice?
The practice location is 46 Albion St, Bridgeport, CT 06605-2602. The office can be reached at 203-330-6000 (phone) or 203-330-6008 (fax).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1144654666 directly on the NPPES registry website.