Individual
MICHELLE MARIE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
1600 DR MARTIN LUTHER KING JR ST N, ST PETERSBURG, FL 33704-4204
(727) 323-3838
(727) 456-0751
Mailing address
PO BOX 748817, ATLANTA, GA 30374-8817
(813) 286-0333
(813) 282-1806
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
APRN11014117
FL
367A00000X
Advanced Practice Midwife
Primary
APRN11014117
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
APRN11014117
LICENSE
FL
Enumeration date
07/08/2021
Last updated
01/24/2024
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