Courtney L. Ellis PA
Physician Assistant in Matthews, NC(View on Map)
Full Name
Courtney Lynn Ellis PA
NPI Number
1144234923
NPI Type
Individual Provider
Gender
Female
Enumeration Date
07/28/2006
Specialties
(Taxonomies)Licenses
State
North Carolina
License Number
103318
Contact
Information
Purpose
Mailing
Location
Address
PO BOX 19305
332 N TRADE ST
City
Charlotte
Matthews
State
NC
NC
Postal Code
28219-9305
28105-1728
Country
US
US
Telephone Number
N/A
(704) 512-6820
Health Information Exchange
Endpoint Type
DIRECT
CONNECT
Endpoint
cellis128420@CarolinasHealthcareSystem.direct-ci.com
https://esmd.abilitynetwork.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service
Endpoint Description
Unknown
2.16.840.1.113883.3.667.2
Use
Unknown
Other
Content Type
Unknown
Unknown
Affiliation
Y
Y
Endpoint Location
Atrium Health332 N Trade StSte 1500Matthews, NC281051728US
ABILITY Network100 N 6th St Ste 900AMinneapolis, MN554031516US
Provider data last refreshed from NPPES NPI registry on 11/19/2024
Data last updated by provider on 07/15/2024
Provider Address
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