Individual
MICHELLE L ELLENBURG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
9100 N MAY AVE, OKLAHOMA CITY, OK 73120-4417
(405) 840-4456
(405) 840-4295
Mailing address
9100 N MAY AVE, OKLAHOMA CITY, OK 73120-4417
(405) 840-4456
(405) 840-4295
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
102324
OK
Other
Enumeration date
06/02/2015
Last updated
02/08/2022
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