Marilyn E Ellis, NURSE PRACTITIONER

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R566624 Issued in MS

Practice address

400 Veterans Ave
Biloxi, MS 39531-2410

Phone

(228) 523-5000

Fax

(228) 523-4322

NPI assigned

Jun 16, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235174285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14256 CARRIAGE CIR",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395035040",
            "telephone_number": "228-832-1926",
            "fax_number": "228-523-4322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VETERANS AVE",
            "city": "BILOXI",
            "state": "MS",
            "postal_code": "395312410",
            "telephone_number": "228-523-5000",
            "fax_number": "228-523-4322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "MARILYN",
        "middle_name": "E",
        "name_prefix": "Ms.",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-16",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MS",
            "license": "R566624",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN 028339 APO1951",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Allan Keith Elliott, RPH
• Shianne Elliott
• Tara Elliott, OTR/L
• Earl Ellis, D.D.S., M.S
• Jonathan Edward Ellis, M.D.
• Bryan Allen Ellsberry, OTR/L
• Kaitlyn Ellsworth
• Emeritus Corporation
• Empower Minds LLC
• Encore Rehabilitation Inc

• Adult Health Nurse Practitioner in Biloxi, MS
• Providers in Biloxi, MS by specialty
• Adult Health Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.