Provider Demographics
NPI:1619610904
Name:RONNIGER, ELLA GRACE
Entity Type:Individual
Prefix:
First Name:ELLA
Middle Name:GRACE
Last Name:RONNIGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 CEDAR RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:VERSAILLES
Mailing Address - State:KY
Mailing Address - Zip Code:40383-9267
Mailing Address - Country:US
Mailing Address - Phone:859-753-6269
Mailing Address - Fax:
Practice Address - Street 1:146 DEWEESE ST
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40507-1921
Practice Address - Country:US
Practice Address - Phone:859-785-8585
Practice Address - Fax:859-888-9980
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker