Individual
MRS. VICKIE EILEEN ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN/CNP
Contact information
Practice address
201 W. KENYON RD, CHAMPAIGN, IL 61820-7892
(217) 531-5365
(217) 531-5378
Mailing address
201 W KENYON RD, CHAMPAIGN, IL 61820-7892
(217) 531-5365
(217) 531-5378
Taxonomy
Speciality
Code
Description
License number
State
363LX0001X
Obstetrics & Gynecology Nurse Practitioner
Primary
209002125
IL
Other
Enumeration date
05/22/2009
Last updated
08/17/2012
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