Individual
ANGELA ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CD, CLC
Contact information
Practice address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 267-6655
Mailing address
2555 N DR MARTIN LUTHER KING JR DR, MILWAUKEE, WI 53212-2709
(414) 267-6655
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1057668
—
Other
Enumeration date
12/10/2019
Last updated
12/10/2019
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