MEDICARE: MELISSA ELLIS FNP

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
1	363L00000X	Nurse Practitioner	CNP261109	ME

General Provider Information

NPI Number	:	1851800460
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA ELLIS FNP

Provider Business Mailing Address
First Line	:	360 US HIGHWAY 1 BYP UNIT 102
Second Line	:
City	:	PORTSMOUTH
State	:	NH
Zip	:	03801-7105
Country	:	US
Telephone Number	:	603-410-6700
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 KNOWLTON CORNER RD
Second Line	:
City	:	FARMINGTON
State	:	ME
Zip	:	04938-6209
Country	:	US
Telephone Number	:	207-578-7152
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2017
Last Update Date	:	03/24/2026

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