Healthcare Provider Details

I. General information

NPI: 1518955822
Provider Name (Legal Business Name): CAROL ANN ELLERTSON ARNP, MS, CNM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MS. CAROL ANN JAMES

II. Dates (important events)

Enumeration Date: 10/11/2005
Last Update Date: 07/20/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1015 DUFF AVE
AMES IA
50010-3014
US

IV. Provider business mailing address

1015 DUFF AVE
AMES IA
50010-3014
US

V. Phone/Fax

Practice location:
  • Phone: 515-239-4414
  • Fax: 515-239-4786
Mailing address:
  • Phone: 515-239-4414
  • Fax: 515-239-4786

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberB059680
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: