Individual
MELANIE W. ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RNC-NIC, NNP-BC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 815-7100
Taxonomy
Speciality
Code
Description
License number
State
363LN0005X
Critical Care Neonatal Nurse Practitioner
Primary
R862363
MS
Other
Enumeration date
03/08/2012
Last updated
06/21/2012
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