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Individual
KELLY ANNE ELLISON
Active
Individual
KELLY ANNE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
AP127337
TX
363LF0000X
Family Nurse Practitioner
Primary
AP127337
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PENDING
BCBS
TX
05
—
PENDING
—
TX
Enumeration date
02/18/2015
Last updated
08/07/2025
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