Individual
EMILY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
4917 S 3450 W, ROY, UT 84067-8643
(801) 458-1103
Mailing address
4917 S 3450 W, ROY, UT 84067-8643
(801) 458-1103
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
9901976-3102
UT
163WP2201X
Ambulatory Care Registered Nurse
9901976-3102
UT
Other
Enumeration date
07/10/2025
Last updated
07/10/2025
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