Individual
GAYLE M. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 RAY O VAC DR, SUITE 220, MADISON, WI 53711-2479
(608) 276-9191
(608) 276-9144
Mailing address
700 RAY O VAC DR, SUITE 220, MADISON, WI 53711-2479
(608) 276-9191
(608) 276-9144
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
2432-057
WI
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
—
WI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
1526-033
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3914300
—
WI
Enumeration date
12/27/2006
Last updated
09/11/2025
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