Individual
GREGORY RICHARD ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3028 PEMBERTON DR APT 5, TOLEDO, OH 43606-2916
(419) 262-4103
Mailing address
3028 PEMBERTON DR APT 5, TOLEDO, OH 43606-2916
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0040771
OH
Other
Enumeration date
11/12/2025
Last updated
11/12/2025
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