Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mark Alan Ellett, AGACNP

Individual provider Critical Care Medicine Registered Nurse · NPI 1295402089

Mark Alan Ellett, AGACNP is a Critical Care Medicine Registered Nurse in Idaho Falls, Idaho. Works from 2 locations. Licensed in Idaho.

Licensed in
ID
In the registry since
2021
Specialties on file
2

Practice location Address checks out

3100 Channing Way
Idaho Falls, ID 83404-7533
Phone: (208) 604-1715
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3817 Nora St, Pocatello, ID 83204-2023 — (208) 604-1715

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 69540 (ID)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence 45067 (ID)

Record details

NPI number1295402089
Entity typeIndividual (Type 1)
GenderMale
Credentials AGACNP
Sole proprietorNo
NPI enumeratedAugust 27, 2021
Last updated in NPPESAugust 30, 2021
Certification dateAugust 30, 2021
Mailing address3817 Nora St, Pocatello, ID 83204-2023

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