MISHELL ELLIS (NPI# 1811325764) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811325764 |
| Entity Type | Individual |
| Full Name | MISHELL ELLIS |
| Credential | FNP-BC |
| Practice Address |
1201 Sam Perry Blvd Fredericksburg VA 22401-4490 |
| Practice Telephone | 5403612922 |
| Mailing Telephone | 5403612922 |
| Enumeration Date | 2013-10-30 |
| Last Update Date | 2017-02-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LF0000X |
Nurse Practitioner Specialization: Family |
0024174257 | VA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363LF0000X |
Nurse Practitioner Specialization: Family |
RN234444 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | STATE LICENSE | RN234444 | 01 |
| VA | VIRGINIA NURSE PRACTITIONER LICENSE | 0024174257 | 01 |
| Street Address |
1201 SAM PERRY BLVD |
| City | FREDERICKSBURG |
| State | VA |
| Zip Code | 22401-4490 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215471941 | Brittany Jillian Cary | Nurse Practitioner | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2016-12-14 |
| 1821259557 | Melissa Ann Chambers | Clinic/Center | 1201 Sam Perry Blvd, Suite 101, Fredericksburg, VA 22401-4490 | 2008-06-25 |
| 1457552143 | Lynn Anne Delash | Occupational Therapist | 1201 Sam Perry Blvd, Suite 240, Fredericksburg, VA 22401-4490 | 2007-05-30 |
| 1992906010 | Karen Anne Franklin | Physical Therapist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-29 |
| 1801097738 | Susan Patricia Rohde | Speech-Language Pathologist | 1201 Sam Perry Blvd, Ste 240, Fredericksburg, VA 22401-4490 | 2007-05-29 |
| 1013128461 | Susan Reiko Hoshi | Physical Therapist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-25 |
| 1285845198 | Stephanie Noelle Campbell | Speech-Language Pathologist | 1201 Sam Perry Blvd, Suite 240, Fredericksburg, VA 22401-4490 | 2007-05-24 |
| 1932319712 | Shauna Renee Dickinson | Speech-Language Pathologist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-23 |
| 1003026444 | Carol Gaudio | Occupational Therapy Assistant | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-23 |
| 1861602211 | Kimberly Jackson | Occupational Therapist | 1201 Sam Perry Blvd, Fredericksburg, VA 22401-4490 | 2007-05-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1992313415 | Amanda Dodd | Behavior Technician | 1411 Princess Anne, Fredericksburg, VA 22401 | 2020-07-21 |
| 1215567326 | Britteny Whitaker | Behavior Technician | 1411 Princess Ann, Fredericksburg, VA 22401 | 2020-01-17 |
| 1396389433 | Ashley Stanevich | Behavior Technician | 1411 Princess Anne Lane, Fredericksburg, VA 22401 | 2019-11-01 |
| 1265074231 | Anna Kelleher | Behavior Technician | 1411 Princess Anna St, Frericksburg, VA 22401 | 2019-10-11 |
| 1649824152 | Zaan Z Ali | Audiologist | 1708 Fall Hill Ave Suite 100, Fredericksburg, VA 22401 | 2019-08-01 |
| 1790342426 | Michael Williams Jr. | Physician Assistant | 411 B Park Hill Dr, Frederickburg, VA 22401 | 2019-05-29 |
| 1285290965 | Ann Damalie Namabiro | Behavior Technician | 1411 Princess Ann Street, Fredericksburg, VA 22401 | 2019-05-17 |
| 1922579630 | Primary and Urgent Care LLC | Family Medicine | Primary and Urgent Care LLC, 2306 Plank Road Ste 100, Fredericksburg, VA 22401 | 2018-12-07 |
| 1003323056 | Mariah Mazzariello | Behavior Technician | 1411 Princess Anne Stree, Fredericksburg, VA 22401 | 2017-12-29 |
| 1336655281 | Hina Zafar | Behavior Technician | 1411 Princess Anne St., Fredericksburg, VA 22401 | 2017-12-14 |
| Find all providers in zip 22401 | ||||
| Taxonomy Code | 363LF0000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Family |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922614049 | Christina Jolene Macfarlane | Nurse Practitioner | 6313 Forest Grove Dr, Fredericksburg, VA 22407-6343 | 2020-09-23 |
| 1912548876 | Carina Leite | Nurse Practitioner | 2306 Plank Rd Ste 100, Fredericksburg, VA 22401-4902 | 2019-10-02 |
| 1821643081 | Emily Torres | Nurse Practitioner | 621 Jefferson Davis Hwy Ste 201, Fredericksburg, VA 22401-4567 | 2019-08-05 |
| 1316468465 | Samantha Martin | Nurse Practitioner | 1975 Jefferson Davis Hwy, Fredericksburg, VA 22401-5298 | 2017-06-29 |
| 1568904399 | Michele Lyn Lattimer | Nurse Practitioner | 2601 Fall Hill Avenue, Fredericksburg, VA 22401 | 2016-11-10 |
| 1457757460 | Karen Julia Gardella | Nurse Practitioner | 3038 Patriot Ln, Fredericksburg, VA 22408-1728 | 2014-11-18 |
| 1144629734 | Amy Taylor | Nurse Practitioner | 1020 Hwy 16, Fredericksburg, TX 78624 | 2014-08-19 |
| 1801200357 | Brooke Renae Sparks | Nurse Practitioner | 10718 Ballantraye Dr., Fredericksburg, VA 22407 | 2014-06-12 |
| 1487096731 | Carol Elizabeth Drever | Nurse Practitioner | 1301 Sam Perry Boulevard (moss Free Clinic), Suite 100, Fredericksburg, VA 22401 | 2013-07-26 |
| 1649529025 | Carlene Gordon | Nurse Practitioner | 125 Olde Greenwich Drive, Suite 220, Fredericksburg, VA 22408-4010 | 2012-08-31 |
| Find all providers in FREDERICKSBURG | ||||
| City | FREDERICKSBURG |
| Zip Code | 22401 |
Please comment or provide details below to improve the information on MISHELL ELLIS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.