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NPI Code Detail

MEDICARE: MRS. LINDSAY CELESTE ELLERT PNP

MEDICARE: MRS. LINDSAY CELESTE ELLERT PNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LP0200XPediatric Nurse Practitioner71003975AIN

General Provider Information

NPI Number : 1336498989
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDSAY CELESTE ELLERT PNP
Provider Business Mailing Address
First Line : 306 E MAUMEE ST STE 303
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2044
Country : US
Telephone Number : 260-665-8494
Fax Number : 260-667-5564
Provider Business Practice Location Address
First Line : 306 E MAUMEE ST STE 303
Second Line :
City : ANGOLA
State : IN
Zip : 46703-2044
Country : US
Telephone Number : 260-665-8494
Fax Number : 260-667-5564
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/29/2012
Last Update Date : 05/01/2019

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