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1619102456
VICKIE EILEEN ELLIS
CHAMPAIGN, IL
NPI
1619102456
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: IL 209002125)
Enumeration Date
2009-05-22
Last Update Date
2012-08-17
Business Address
Mrs. VICKIE EILEEN ELLIS APN/CNP
201 W. KENYON RD
CHAMPAIGN, IL 61820-7892
Phone number: 217-531-5365
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Mailing Address
Mrs. VICKIE EILEEN ELLIS APN/CNP
201 W KENYON RD
CHAMPAIGN, IL 61820-7892
Phone number: 217-531-5365
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