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Individual

MONICA NICOLE ELLIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
402 WESLEY AVE STE 200, JACKSON, MS 39202-1000
(601) 835-5951
Mailing address
402 WESLEY AVE, JACKSON, MS 39202-1000
(769) 777-1411

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
905990
MS

Other

Enumeration date
09/06/2023
Last updated
07/16/2024
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