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General NPI Number Information
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NPI Number | 1225178346
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Entity Type | Individual
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Provider Name | KARYN MARIE ELLIS DNP, RN
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Gender | Female
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Dates
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Enumeration Date | 02/07/2007
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Last Update Date | 06/06/2023
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Provider Practice Location Address
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Address Line | 10 BRAMBLE BUSH DR
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City | FALMOUTH
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State | MA
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Zip | 02540-2325
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Country | US
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Telephone | 180-150-8540
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Fax |
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Provider Business Mailing Address
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Address Line | 3 NOEL HENRY DR
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City | EAST SANDWICH
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State | MA
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Zip | 02537-1497
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 264507
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 264507
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License Number State | MA
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