Individual
MELODY ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1880 N EASTMAN RD STE 130, KINGSPORT, TN 37664-2385
(423) 915-6765
Mailing address
1220 RIVERBEND DR APT 107, KINGSPORT, TN 37664-4094
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
41531
TN
Other
Enumeration date
03/18/2026
Last updated
03/18/2026
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