Brianna Ellis

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Haughton, LA

NPI 1104735638 · NPPES record last updated Sep 2, 2026

Key facts

NPI
1104735638
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
353 Camden HL
Haughton, LA 71037-8779
Phone
(318) 617-3503
NPI assigned
Sep 2, 2026
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

353 Camden HL
Haughton, LA 71037-8779

Mailing address

353 Camden HL
Haughton, LA 71037-8779

Other providers in Haughton, LA

All providers in Haughton, LA · Student in an Organized Health Care Education/Training Program in Louisiana

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 2, 2026. Information in NPPES is self-reported and not verified by CMS.
  • NUCC Health Care Provider Taxonomy: specialty names.

Verify at the official NPI Registry.