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Contact Information

SUSAN ELLIS, PNP
1609 CEDAR ST
MUSCATINE, IA52761-3426
 Phone: 563-263-0122
 Fax: 563-263-0520
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for SUSAN ELLIS · (Female)

NPI Number 1871631796
Status Active
Credentials PNP
Entity Individual
Enumeration date 02/02/2007
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • IA License # C-079193
  • IA Other 22315 BLUE CROSS BLUE SHIELD
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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