Individual
EMILY MICHELLE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
6101 PINE RIDGE RD # DESK10, NAPLES, FL 34119-3900
(239) 649-1662
(877) 334-1886
Mailing address
3451 PINE RIDGE RD BLDG 601, NAPLES, FL 34109-3922
(239) 449-3072
(877) 334-1886
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP654323
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E420213858290
FLORIDA DRIVERS LICENSE
FL
Enumeration date
05/19/2022
Last updated
10/06/2022
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