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General NPI Number Information
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NPI Number | 1962705103
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Entity Type | Individual
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Provider Name | KELLY ELIZABETH ELLIS APN, CNM
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Gender | Female
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Dates
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Enumeration Date | 12/09/2010
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Last Update Date | 12/15/2025
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Provider Practice Location Address
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Address Line | 5000 E MAIN ST
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City | COLUMBUS
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State | OH
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Zip | 43213-2440
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Country | US
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Telephone | 614-235-5555
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Fax | 614-536-1994
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Provider Business Mailing Address
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Address Line | 5000 E MAIN ST
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City | COLUMBUS
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State | OH
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Zip | 43213-2440
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Country | US
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Telephone | 614-235-5555
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Fax | 614-536-1994
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number | 209008508
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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License Number |
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License Number State |
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