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Individual
PETRINA F. ELLIS
Active
Individual
PETRINA F. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
625326
NY
207R00000X
Internal Medicine Physician
F349223
NY
363LF0000X
Family Nurse Practitioner
Primary
F349223
NY
363LF0000X
Family Nurse Practitioner
RN253453
GA
Other
Enumeration date
02/03/2012
Last updated
02/12/2025
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