Provider Demographics
NPI:1255882478
Name:NEWHOUSE, ELLEN MARGARET (APRN)
Entity type:Individual
Prefix:
First Name:ELLEN
Middle Name:MARGARET
Last Name:NEWHOUSE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 390
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:WV
Mailing Address - Zip Code:25708-0390
Mailing Address - Country:US
Mailing Address - Phone:304-429-1088
Mailing Address - Fax:304-429-3109
Practice Address - Street 1:108 W MADISON ST
Practice Address - Street 2:
Practice Address - City:LOUISA
Practice Address - State:KY
Practice Address - Zip Code:41230-1327
Practice Address - Country:US
Practice Address - Phone:606-826-0341
Practice Address - Fax:606-826-0349
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2024-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVAPRN40531-FNP-BC363LF0000X, 363LF0000X
KY3010656363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0308110Medicaid
WV1255882478Medicaid
KY7100482340Medicaid