Hannah Nicole Ellis
Individual provider Active NPI Case Manager/Care Coordinator · Dierks, AR
NPI 1619607447 · NPPES record last updated Jun 14, 2022
Key facts
- NPI
- 1619607447
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Case Manager/Care Coordinator 171M00000X
- Practice address
- 1124 Main Ave
Dierks, AR 71833-9421 - Phone
- (870) 784-0884
- Fax
- (870) 825-2060
- NPI assigned
- Jun 14, 2022
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Impact Counseling Clinic, Incorporated | Current |
Accepting new patients |
Interoperability endpoints
- https://api.platform.athenahealth.com/25972/brand/1/csg/1/fhir/r4
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Yes |
Addresses
Primary practice location
1124 Main Ave
Dierks, AR 71833-9421
Mailing address
PO Box 575
Dierks, AR 71833-0575
Phone (870) 784-0884
Other providers in Dierks, AR
- Justin Bean
- Kelsi Dawn Brown
- Dierks Health Opco LLC
- Dierks Healthcare & Rehabilitation Center LLC
- Dierks School District
- Priscilla Ann Faulkner
- Shelby Gail Foshee
- Robert Ernest Gunter
- Impact Counseling Clinic, Incorporated
- Jen&Josh Inc
All providers in Dierks, AR · Case Manager/Care Coordinator in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 14, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.