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NPI Code Detail

MEDICARE: MRS. ERIN RAY ANN ELLIS RN, MS, FNP-BC

MEDICARE:  MRS. ERIN RAY ANN ELLIS  RN, MS, FNP-BC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse PractitionerAPN 196NV

General Provider Information

NPI Number : 1548221583
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ERIN RAY ANN ELLIS RN, MS, FNP-BC
Provider Business Mailing Address
First Line : 1916 SUMMER POINT ST UNIT 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89134-2645
Country : US
Telephone Number : 702-806-1997
Fax Number :
Provider Business Practice Location Address
First Line : 7040 SMOKE RANCH RD
Second Line :
City : LAS VEGAS
State : NV
Zip : 89128-8607
Country : US
Telephone Number : 702-792-6700
Fax Number : 401-652-9787
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/29/2006
Last Update Date : 11/02/2016

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Directions to “ MRS. ERIN RAY ANN ELLIS RN, MS, FNP-BC” Practice Location

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