Individual
MATTHEW RYAN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN, AG-ACNP
Contact information
Practice address
1400 S COULTER ST, AMARILLO, TX 79106-1786
(806) 414-9558
Mailing address
2223 S HUGHES ST, AMARILLO, TX 79109-2213
(806) 702-0777
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
1089531
TX
Other
Enumeration date
08/10/2022
Last updated
08/11/2022
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