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Kathleen Dunlevy Ellis, PA-C
Surgical Physician Assistant in Mishawaka, Indiana
NPI 1891570545

Kathleen Dunlevy Ellis is a Surgical Physician Assistant based in South Bend, IN and is specialized in Surgical. Kathleen Dunlevy Ellis practices in Mishawaka, IN and has the professional credentials of PA-C. The NPI Number for Kathleen Dunlevy Ellis is 1891570545 and holds a License No. 10004107A (Indiana).

The current practice location address for Kathleen Dunlevy Ellis is 611 E Douglas Rd Ste 208, Mishawaka, IN and can be reached out via phone at 317-714-8752.

Location: 611 E Douglas Rd Ste 208, Mishawaka, IN, 46617-2059
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Provider Profile Details
NPI Number
1891570545
Provider Name
Kathleen Dunlevy Ellis
Credential
PA-C
Provider Entity Type
Individual
Gender
Female
Address
611 E Douglas Rd Ste 208, Mishawaka, IN, 46617-2059
Phone Number
317-714-8752
Fax Number
Provider Enumeration Date
08/30/2023
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
300080410 05 IN
institution
Provider Business Practice Location Address Details
Address
611 E Douglas Rd Ste 208
City
State
Zip
46545-1465
Phone Number
317-714-8752
Fax Number
person
Provider Business Mailing Address Details
Address
611 E Douglas Rd Ste 208
City
State
Zip
46545-1465
Phone Number
317-714-8752
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Surgical
Taxonomy
License No.
10004107A (Indiana)
Definition
Definition to come...
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