Provider Demographics
NPI:1336498989
Name:ELLERT, LINDSAY CELESTE (PNP)
Entity Type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:CELESTE
Last Name:ELLERT
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
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Mailing Address - Street 1:306 E MAUMEE ST STE 303
Mailing Address - Street 2:
Mailing Address - City:ANGOLA
Mailing Address - State:IN
Mailing Address - Zip Code:46703-2044
Mailing Address - Country:US
Mailing Address - Phone:260-665-8494
Mailing Address - Fax:260-667-5564
Practice Address - Street 1:306 E MAUMEE ST STE 303
Practice Address - Street 2:
Practice Address - City:ANGOLA
Practice Address - State:IN
Practice Address - Zip Code:46703-2044
Practice Address - Country:US
Practice Address - Phone:260-665-8494
Practice Address - Fax:260-667-5564
Is Sole Proprietor?:No
Enumeration Date:2012-08-29
Last Update Date:2019-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71003975A363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics