Individual
MADELYNE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1159 WALTER TAYLOR RD, FRIENDSHIP, TN 38034-3449
(931) 787-4062
Mailing address
60 PHYSICIANS LN, SOUTHAVEN, MS 38671-6122
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
35673
TN
Other
Enumeration date
10/04/2024
Last updated
10/04/2024
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