Individual
ELLIE BULLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
303 N JACKSON ST, MORRISON, IL 61270-3042
(815) 772-4003
Mailing address
303 N JACKSON ST, MORRISON, IL 61270-3042
(815) 772-4003
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209029380
IL
363L00000X
Nurse Practitioner
A167150
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
209029380
IL ARNP LICENSE
IL
01
—
A167150
IOWA ARNP LICENSE
IA
Enumeration date
02/03/2022
Last updated
01/23/2025
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