Individual
ANITRA MARIE ELLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
50 LENORE BUSINESS CENTER, WILLIAMSON, WV 25661
(304) 475-3700
Mailing address
PO BOX 754, CHAPMANVILLE, WV 25508-0754
(304) 855-6121
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
APRN81437-NP-C
WV
363LF0000X
Family Nurse Practitioner
Primary
WV81437
WV
Other
Enumeration date
07/21/2016
Last updated
11/14/2016
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