Individual
TRACI LYNNETTE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1313 S ST STE A, BRIDGEPORT, NE 69336-2563
(308) 262-1755
(308) 262-0765
Mailing address
1313 S ST STE A, BRIDGEPORT, NE 69336-2563
(308) 262-1755
(308) 262-0765
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
111534
NE
Other
Enumeration date
12/10/2013
Last updated
05/12/2020
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