NPI 1831458744 · live from the CMS NPI Registry
Carissa Annette Ellsworth, Physician Assistant
Physician Assistant, Medical in Layton, UT. National Provider Identifier 1831458744, active.
NPI record
| NPI | 1831458744 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant, Medical 363AM0700X |
| Practice location | 1600 W Antelope Dr, Layton, UT 84041 |
| Practice phone | 801-807-7177 |
| Mailing address | 1022 28th St W, Williston, ND 58801 |
| Enumerated | May 11, 2012 |
| Last updated | October 23, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant, Medical primary | 363AM0700X | PAC-0481 (ND) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.