Individual
SHELLY ANN ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 MAPLE HILL AVE, NEWINGTON, CT 06111-2719
(631) 575-7769
Mailing address
30 MAPLE HILL AVE, NEWINGTON, CT 06111-2719
(631) 575-7769
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
554311
NY
Other
Enumeration date
08/19/2025
Last updated
08/19/2025
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