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Individual
DONNA ELLIS
Active
Individual
DONNA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OGNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
800002
NC
363LW0102X
Women's Health Nurse Practitioner
800002
NC
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
800002
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21258
CERTIFICATION
NC
01
—
800002
LICENSE
NC
Enumeration date
10/17/2006
Last updated
11/25/2009
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