Provider Demographics
NPI:1821304817
Name:CURRO, ELLEN LOUISE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:ELLEN
Middle Name:LOUISE
Last Name:CURRO
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8106 STAYTON DR STE D
Mailing Address - Street 2:
Mailing Address - City:JESSUP
Mailing Address - State:MD
Mailing Address - Zip Code:20794-9615
Mailing Address - Country:US
Mailing Address - Phone:301-520-1673
Mailing Address - Fax:866-289-9771
Practice Address - Street 1:8106 STAYTON DR STE D
Practice Address - Street 2:
Practice Address - City:JESSUP
Practice Address - State:MD
Practice Address - Zip Code:20794-9615
Practice Address - Country:US
Practice Address - Phone:301-520-1673
Practice Address - Fax:866-289-9771
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-27
Last Update Date:2010-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDC0000733363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical