Individual
STEFANIE R ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2301 HOLMES ST, KANSAS CITY, MO 64108-2640
(816) 404-1536
Mailing address
2310 HOLMES ST, STE 800, KANSAS CITY, MO 64108-2634
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
112705
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
203987409
—
MO
Enumeration date
03/30/2006
Last updated
11/30/2020
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