Individual
CHRISTINE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
12902 USF MAGNOLIA DR, MDC 44, TAMPA, FL 33612-9416
(813) 745-4673
Mailing address
PO BOX 198441, ATLANTA, GA 30384-8441
(813) 745-7365
(813) 449-8618
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
ARNP1504612
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306163900
—
FL
01
—
Y049S
BCBS
FL
Enumeration date
07/12/2006
Last updated
04/04/2025
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