Individual provider · Type 1 NPI
Anthony Ellis, NP
Family Nurse Practitioner · San Jose, CA
NPI number
1063922771
Active
Practice location
2105 Forest Ave
San Jose, CA 95128-1425
Mailing address
44280 Revere Pl
Fremont, CA 94539-5902
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 95007645 (CA) |
Family Nurse Practitioner: Definition to come...
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About NPI 1063922771
Anthony Ellis, NP's National Provider Identifier is 1063922771, issued on Oct 7, 2017. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in San Jose, CA. The record was last updated on Oct 7, 2017.