# ALICE J ELLISON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1114780228
- **Gender:** F
- **Credential:** FNP-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2083P0901X | Public Health & General Preventive Medicine Physician | 2023045679 | MO | Yes |

## Other

- **Enumeration date:** 02/01/2024
- **Last updated:** 02/05/2024