Ellis, Amanda

Ellis, Amanda is an sole proprietor health care provider with primary practice located at 4500 13Th St Ste 900 , Gulfport MS 39501-2515. She recently has 3 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Ellis, Amanda can be contacted via phone (228) 867-4000.

Contact Information

Primary practice address
4500 13Th St Ste 900 Gulfport MS 39501-2515
Phone: (228) 867-4000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 888645 Mississippi
Nursing Service Providers / Critical Care Medicine 163WC0200X 888645 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 906495 Mississippi

Profile Details

NPI number 1538827860
LBN Legal business name Ellis, Amanda
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 3rd, 2021
Last updated Apr 10th, 2024 - about 5 months ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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