# MICHELLE L ELLIS

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

## Provider details

- **NPI number:** 1790792372
- **Gender:** F
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | 22568 | NE | Yes |

## Other

- **Enumeration date:** 08/03/2006
- **Last updated:** 02/28/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 01-05989 | UHC | NE |
| 01 | — | 07330 | BCBS | NE |
| 01 | — | 237252 | MIDLAND'S CHOICE | NE |
| 05 | — | 470780857 12 | — | NE |