Individual provider · Type 1 NPI
Shane P. Ellis, CRNP ANP BC
Adult Health Nurse Practitioner · Baltimore, MD
NPI number
1629325972
Active
Practice location
22 S Greene St
Baltimore, MD 21201-1544
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | R144232 (MD) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1629325972
Shane P. Ellis, CRNP ANP BC's National Provider Identifier is 1629325972, issued on Aug 6, 2012. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Baltimore, MD. The record was last updated on Aug 6, 2012.