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General NPI Number Information
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NPI Number | 1265965008
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Entity Type | Individual
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Provider Name | DAVID CHARLES ELLNER RN, BCEN, CVRN
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Gender | Male
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Dates
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Enumeration Date | 04/08/2017
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 206 2ND ST E
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City | BRADENTON
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State | FL
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Zip | 34208-1000
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Country | US
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Telephone | 941-746-5111
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Fax |
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Provider Business Mailing Address
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Address Line | 61 BELEM ST
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City | PUNTA GORDA
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State | FL
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Zip | 33983-5203
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Country | US
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Telephone | 941-626-0960
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Fax | 209-653-0960
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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 | 146L00000X
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Taxonomy Name | Paramedic
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License Number | PMD206372
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 96194
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License Number State | CT
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Taxonomy #3
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | 638056-1
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License Number State | NY
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Taxonomy #4
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Taxonomy Code | 163WE0003X
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Taxonomy Name | Emergency Registered Nurse
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License Number | RN9314202
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License Number State | FL
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