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

KATHLEEN DUNLEVY ELLIS, PA-C

Active

KATHLEEN DUNLEVY ELLIS, PA-C is a Surgical Physician Assistant healthcare provider located in MISHAWAKA, Indiana. NPI 1891570545 is currently active in the NPPES registry. Verify at CMS.

Surgical Physician Assistant · MISHAWAKA, IN

Registration Details

NPI Number
1891570545
Provider Type
Individual
Gender
Female
NPI Issued
Aug 30, 2023 (2.9648308602994 yrs)
Last Updated
Jan 13, 2026
License
10004107A (IN)

Practice Information

Address
611 E DOUGLAS RD STE 207
MISHAWAKA, IN, 465451465
Browse IN providers · Browse ZIP 46545
Phone
5743356850
Primary Specialty
Surgical Physician Assistant
363AS0400X
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.