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Mark Ellett, AGACNP — NPI 1295402089, Idaho Falls, ID | NPI Central

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NPI 1295402089

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Mark Ellett, AGACNP

NPI 1295402089 · Acute Care Nurse Practitioner · Idaho Falls, ID

Provider details

NPI number: 1295402089
Entity type: Individual
Primary specialty: Acute Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Credential: AGACNP
Sex: Male
Sole proprietor: No
License: 45067 (ID)

Specialties & taxonomies

Acute Care Nurse PractitionerPrimary363LA2100XLicense 69540 (ID)
Physician Assistants & Advanced Practice Nursing Providers
Critical Care Medicine Registered Nurse163WC0200XLicense 45067 (ID)
Nursing Service Providers

Practice location

3100 Channing Way

Idaho Falls, ID 83404-7533

Phone: (208) 604-1715

Approximate (ZIP-level) locationGet directions

More ID providers

Mailing address

3817 Nora St

Pocatello, ID 83204-2023

Additional practice locations (1)

3817 Nora St
Pocatello, ID 83204-2023
Phone: (208) 604-1715

Registry dates

Enumerated: 2021-08-27
Last updated: 2021-08-30
Certified: 2021-08-30

Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.