Individual
MELISSA ANNE ELLINGSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, PNP
Contact information
Practice address
12455 E 100TH ST N STE 300, OWASSO, OK 74055-4678
(918) 274-9700
(918) 274-1395
Mailing address
12455 E 100TH ST N STE 300, OWASSO, OK 74055-4678
(918) 274-9700
(918) 274-1395
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
0024170262
VA
363LP0200X
Pediatric Nurse Practitioner
121520
OK
363LP0200X
Pediatric Nurse Practitioner
Primary
R187505
MD
Other
Enumeration date
09/30/2011
Last updated
08/12/2021
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