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Individual
MARY ELLIS
Active
Individual
MARY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
55813
NE
2084P0800X
Psychiatry Physician
113044
NE
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
113044
NE
Other
Enumeration date
04/25/2014
Last updated
02/04/2025
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