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NPI Code Detail

MEDICARE: MRS. NELLY ELLA CHOUDJA APRN

MEDICARE: MRS. NELLY ELLA CHOUDJA APRN
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 Practitioner11017866FL

General Provider Information

NPI Number : 1508516113
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NELLY ELLA CHOUDJA APRN
Provider Business Mailing Address
First Line : 4915 EHRLICH RD
Second Line :
City : TAMPA
State : FL
Zip : 33624-2038
Country : US
Telephone Number : 614-556-5920
Fax Number :
Provider Business Practice Location Address
First Line : 4915 EHRLICH RD
Second Line :
City : TAMPA
State : FL
Zip : 33624-2038
Country : US
Telephone Number : 614-556-5920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/25/2022
Last Update Date : 03/10/2026

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