Provider Demographics
NPI:1942685151
Name:IGNOWSKI, ELESA L
Entity Type:Individual
Prefix:MRS
First Name:ELESA
Middle Name:L
Last Name:IGNOWSKI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ELESA
Other - Middle Name:L
Other - Last Name:FETTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2620 ELM HILL PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37214-3108
Mailing Address - Country:US
Mailing Address - Phone:615-425-4200
Mailing Address - Fax:
Practice Address - Street 1:1750 W UINTAH ST
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80904-2926
Practice Address - Country:US
Practice Address - Phone:719-325-0344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-29
Last Update Date:2021-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS92861363LF0000X
CO0993073363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily