DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

CONSTANCE COLETTLE ELLIS

Active Sole Proprietor

CONSTANCE COLETTLE ELLIS is a Community Health Worker healthcare provider located in SHREVEPORT, Louisiana. NPI 1104337856 is currently active in the NPPES registry. Verify at CMS.

Community Health Worker · SHREVEPORT, LA

Registration Details

NPI Number
1104337856
Provider Type
Individual
Gender
Female
NPI Issued
Oct 21, 2017 (8.8348073356991 yrs)
Last Updated
May 17, 2018
Sole Proprietor
Yes

Practice Information

Address
9245 WALLACE LAKE RD STE A
SHREVEPORT, LA, 71106
Browse LA providers · Browse ZIP 71106
Phone
3182212828
Primary Specialty
Community Health Worker
172V00000X
Additional Specialty
Community Health Worker

Other Community Health Worker Providers in SHREVEPORT, LA

Name Credential NPI
MR. ROBERT EARL BLOUNT N/A 1528394368
MR. ERIC MARC ERLEWINE MPT 1750605622
KRASHANTA BARRETT PTA 1043692072
TAMA DEMERY 1477906535
JERELL M. COLEMAN B.S., ES 1790232767
EVE SCROGGINS BA 1710434766
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.