Individual
ANJULI ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1301 E SUNSHINE ST, SPRINGFIELD, MO 65804-1143
(417) 889-4800
Mailing address
PO BOX 4046, SPRINGFIELD, MO 65808-4046
(417) 269-5712
(417) 269-7567
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014022535
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801209234
—
MO
Enumeration date
06/03/2014
Last updated
09/08/2020
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