Individual
MARITA WALTON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2400 PATTERSON ST STE 502, NASHVILLE, TN 37203
(615) 515-1900
Mailing address
2400 PATTERSON ST STE 502, NASHVILLE, TN 37203-6511
(615) 515-1900
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
24459
TN
363LA2100X
Acute Care Nurse Practitioner
AP09247
LA
363LA2100X
Acute Care Nurse Practitioner
R898664
MS
Other
Enumeration date
12/17/2014
Last updated
01/22/2019
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