Individual
MELODIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1 MEDICAL VILLAGE DR, EDGEWOOD, KY 41017-3403
(859) 301-8074
(859) 301-4945
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 344-5555
(859) 212-4357
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3010910
KY
Other
Enumeration date
12/19/2016
Last updated
02/07/2022
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