Individual
NEA D ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
790 N MILWAUKEE ST, MILWAUKEE, WI 53202-3724
(414) 207-4860
Mailing address
4577 HOGAN LN, WADSWORTH, IL 60083-8943
(414) 630-6638
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
221100-30
WI
164W00000X
Licensed Practical Nurse
Primary
312273-031
WI
Other
Enumeration date
09/23/2011
Last updated
06/02/2025
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