Individual
MARTY LEON ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, FNP-C
Contact information
Practice address
23020 M RD, HOLTON, KS 66436-8641
(785) 362-8677
Mailing address
23020 M RD, HOLTON, KS 66436-8641
(785) 362-8677
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
81573
KS
Other
Enumeration date
09/27/2022
Last updated
09/27/2022
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