Provider Demographics
NPI:1073015210
Name:CONFORTI, ELLEN KAY (RN)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:KAY
Last Name:CONFORTI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1905 CORI PL
Mailing Address - Street 2:
Mailing Address - City:SACHSE
Mailing Address - State:TX
Mailing Address - Zip Code:75048-2951
Mailing Address - Country:US
Mailing Address - Phone:214-676-6996
Mailing Address - Fax:972-530-2151
Practice Address - Street 1:1905 CORI PL
Practice Address - Street 2:
Practice Address - City:SACHSE
Practice Address - State:TX
Practice Address - Zip Code:75048-2951
Practice Address - Country:US
Practice Address - Phone:214-676-6996
Practice Address - Fax:972-530-2151
Is Sole Proprietor?:No
Enumeration Date:2018-03-04
Last Update Date:2018-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX600691163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse