Individual
ALEXA RENEE ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN, RN, FNP-BC
Contact information
Practice address
225 COMMUNITY DR RM 110, GREAT NECK, NY 11021-5506
(516) 365-3996
Mailing address
225 COMMUNITY DR RM 110, GREAT NECK, NY 11021-5506
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
809745
NY
363LF0000X
Family Nurse Practitioner
Primary
353283
NY
Other
Enumeration date
08/23/2024
Last updated
08/23/2024
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