Individual
AMANDA ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3635 BIENVILLE BLVD, OCEAN SPRINGS, MS 39564-5711
(228) 872-1951
Mailing address
2909 SHELL LANDING BLVD, GAUTIER, MS 39553-5835
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
888645
MS
163WC0200X
Critical Care Medicine Registered Nurse
888645
MS
363L00000X
Nurse Practitioner
Primary
906495
MS
363LC0200X
Critical Care Medicine Nurse Practitioner
906495
MS
Other
Enumeration date
12/03/2021
Last updated
04/16/2026
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