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Individual
TARRYN ELLIS
Active
Individual
TARRYN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
209016755
IL
363LF0000X
Family Nurse Practitioner
Primary
209016755
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
209016755
—
IL
01
—
F09170865
AANP
IL
Enumeration date
05/23/2018
Last updated
06/20/2025
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