Ellis, Mishell

Ellis, Mishell is an individual health care provider with primary practice located at 2244 Executive Dr , Hampton VA 23666-2430. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is her primary health care specialty. Ellis, Mishell can be contacted via phone (757) 827-1001.

Contact Information

Primary practice address
2244 Executive Dr Hampton VA 23666-2430
Phone: (757) 827-1001
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 0024174257 Virginia
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 0024174257 Virginia

Profile Details

NPI number 1811325764
LBN Legal business name Ellis, Mishell
Credentials FNP-BC
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 30th, 2013
Last updated Aug 23rd, 2023 - about last year

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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Identifiers

StateTypeNumberIssuer
All States NPI 1811325764 NPPES
Virginia Other 0024174257 VIRGINIA NURSE PRACTITIONER LICENSE
Virginia Other RN234444 VIRGINIA NURSE PRACTITIONER LICENSE

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