Healthcare Provider Details

I. General information

NPI: 1386557643
Provider Name (Legal Business Name): PAIGE NICOLE ELLIS RN,BSN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1027 MILLSTONE CT
FRANKLIN IN
46131-3600
US

IV. Provider business mailing address

1027 MILLSTONE CT
FRANKLIN IN
46131-3600
US

V. Phone/Fax

Practice location:
  • Phone: 317-502-7074
  • Fax:
Mailing address:
  • Phone: 317-502-7074
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28258723A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: