Individual
MELANIE AMANDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
PO BOX 97, GREEN LAKE, WI 54941-0097
(920) 229-0686
Mailing address
PO BOX 97, GREEN LAKE, WI 54941-0097
(920) 229-0686
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
17426-33
WI
Other
Enumeration date
09/13/2025
Last updated
09/13/2025
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