Individual
MICHELLE L ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
4501 S 70TH ST, STE 140, LINCOLN, NE 68516-4282
(402) 484-5100
(402) 484-5151
Mailing address
8055 O ST, STE 300, LINCOLN, NE 68510-2580
(402) 421-0896
(402) 421-0945
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22568
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-05989
UHC
NE
01
—
07330
BCBS
NE
01
—
237252
MIDLAND'S CHOICE
NE
05
—
470780857 12
—
NE
Enumeration date
08/03/2006
Last updated
02/28/2008
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