Ellis, Genie Marie
Ellis, Genie Marie is an individual health care provider with primary practice located at 3200 Canyon Lake Dr , Rapid City SD 57702-8114. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Ellis, Genie Marie can be contacted via phone (605) 355-2443.Contact Information
Primary practice address
3200 Canyon Lake Dr
Rapid City SD 57702-8114
Phone: (605) 355-2443
Fax: (650) 355-2403
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 0229CNP | South Dakota |
Profile Details
| NPI number | 1649233677 |
|---|---|
| LBN Legal business name | Ellis, Genie Marie |
| Credentials | Family Nurse Practitioner (FNP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 10th, 2006 |
| Last updated | Nov 8th, 2011 - about 13 years 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1649233677 | NPPES |
| South Dakota | MEDICAID | 5549050 |
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