P Praxis·MD
● Active Type 1 · Individual

Mark Alan Ellett, AGACNP

Nurse Practitioner·Idaho Falls, ID· NPI 1295402089 · Enumerated 2021 · 4 years on NPI
Ellett is 1 of 6 nurse practitioner providers in Idaho Falls and 1 of 60 in Idaho.
NPI age
4 years
Enumerated 2021-08-27
Primary specialty
Nurse Practitioner
Plus 1 subspecialty
Licensed in
ID
1 state
Status
Active
No deactivations on record
Last NPPES update
2021-08-30
Source: monthly bulk 2026-05
Sole proprietor
No
May be part of a larger org

How this provider compares

Across 60 active nurse practitioner providers in Idaho.

NPI age
4 years
≈ at median (5 yr)
State licenses
1 state
28% of peers hold multiple states
Subspecialties
1
In the 50% of peers with subspecialties

NPI lifetime · 2021 → 2026

2021-08Enumerated in NPPES
2021 2026

Where they practice

Practice location
3100 Channing Way
Idaho Falls, ID 834047533
📞 2086041715
Mailing address
3817 Nora St
Pocatello, ID 832042023
📞 2086041715

Additional practice locations

1 secondary location on file with NPPES.

Location 2
3817 Nora St
Pocatello, ID 832042023
📞 2086041715

Specialties

  • Nurse Practitioner Primary
    Definition to come...
    ID license #69540 taxonomy 363LA2100X
  • Registered Nurse
    Definition to come...
    ID license #45067 taxonomy 163WC0200X

Practice context

Part of a multi-provider practice. 240 other active providers share this practice address in NPPES.

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How to verify this provider

  1. Confirm the NPI on NPPES.The CMS registry is the system of record. Open NPPES →
  2. Check the state license is currently active.State licensing boards publish current status; NPPES does not.
  3. Confirm payer enrollment if billing.NPI presence does not guarantee active enrollment with Medicare, Medicaid, or commercial payers.

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