Individual
MISS CASEY ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
8325 BROADWAY ST STE 220, PEARLAND, TX 77581-5773
(281) 783-8162
(713) 439-7995
Mailing address
16107 KENSINGTON DR STE 126, SUGAR LAND, TX 77479-4224
(281) 783-8162
(713) 439-7995
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP130690
TX
363LF0000X
Family Nurse Practitioner
AP130690
TX
Other
Enumeration date
03/29/2016
Last updated
04/30/2021
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