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Keith Lawrence Ellis
Pediatric Nurse Practitioner in Bridgeport, Connecticut
NPI 1144654666

Keith Lawrence Ellis is a Pediatric Nurse Practitioner based in Bridgeport, CT and is specialized in Pediatrics. Keith Lawrence Ellis practices in Bridgeport, CT. The NPI Number for Keith Lawrence Ellis is 1144654666 and holds a License No. 5501 (Connecticut).

The current practice location address for Keith Lawrence Ellis is 46 Albion St, Bridgeport, CT and can be reached out via phone at 203-330-6000 and via fax at 203-330-6008. You can also correspond with Keith Lawrence Ellis through the mailing address at 46 ALBION ST, BRIDGEPORT, CT - 06605-2602 (mailing address contact number: 203-330-6000).

Location: 46 Albion St, Bridgeport, CT, 06605-2602
person
Provider Profile Details
NPI Number
1144654666
Provider Name
Keith Lawrence Ellis
Credential
Provider Entity Type
Individual
Gender
Male
Address
46 Albion St, Bridgeport, CT, 06605-2602
Phone Number
203-330-6000
Fax Number
203-330-6008
Provider Enumeration Date
09/03/2013
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
004236136 05 CT
institution
Provider Business Practice Location Address Details
Address
46 Albion St
City
State
Zip
06605-2602
Phone Number
203-330-6000
Fax Number
203-330-6008
person
Provider Business Mailing Address Details
Address
46 Albion St
City
State
Zip
06605-2602
Phone Number
203-330-6000
Fax Number
203-330-6008
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
5501 (Connecticut)
Definition
Definition to come...
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