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Individual

ELLIE TAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSN, CNM, WHNP-BC

Contact information

Practice address
6707 N 19TH AVE STE 222, PHOENIX, AZ 85015-1106
(602) 283-3668
(877) 977-9438
Mailing address
6707 N 19TH AVE STE 222, PHOENIX, AZ 85015-1106
(602) 283-3668
(877) 977-9438

Taxonomy

Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
AP7917
AZ
367A00000X
Advanced Practice Midwife
Primary
AP7917
AZ

Other

Enumeration date
07/02/2015
Last updated
04/13/2022
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