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General NPI Number Information
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NPI Number | 1235522087
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Entity Type | Individual
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Provider Name | CHRISTIE ANN ELLIS
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Gender | Female
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Dates
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Enumeration Date | 03/17/2015
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Last Update Date | 11/14/2023
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Provider Practice Location Address
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Address Line | 480 MAPLE ST SUITE C233A
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City | DANVERS
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State | MA
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Zip | 01923-4065
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Country | US
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Telephone | 978-304-8691
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Fax |
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Provider Business Mailing Address
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Address Line | 9 WOODLAND RD
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City | WAKEFIELD
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State | MA
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Zip | 01880-3120
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | RN2289067
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License Number State | MA
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