# JESSICA ANN ELLIS

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

## Provider details

- **NPI number:** 1831497353
- **Gender:** F
- **Credential:** C.N.M

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 176B00000X | Midwife | — | NULL | — |
| 367A00000X | Advanced Practice Midwife | — | NULL | Yes |

## Other

- **Enumeration date:** 03/08/2011
- **Last updated:** 10/21/2021

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 326666 | GEORGIA LICENSE | GA |
| 01 | — | 39957 | STATE LICENSE NUMBER | MT |