Individual
ANDREA LEE ELLISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
5500 STADIUM PKWY STE 101, MELBOURNE, FL 32940-8095
(321) 306-5510
Mailing address
5500 STADIUM PKWY, MELBOURNE, FL 32940-8422
(321) 306-5510
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
ARNP2151372
FL
Other
Enumeration date
08/13/2012
Last updated
03/23/2023
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