Alphretta Ellis

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

878975 Issued in NV

Practice address

4040 S Eastern Ave Ste 300
Las Vegas, NV 89119-0854

Phone

(313) 768-7334

NPI assigned

Apr 19, 2016

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": "1461024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736208000000",
    "number": "1477907111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13586 INDIANA ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482382308",
            "telephone_number": "313-768-7334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4040 S EASTERN AVE STE 300",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891190854",
            "telephone_number": "313-768-7334"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIS",
        "first_name": "ALPHRETTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-04-19",
        "last_updated": "2025-01-07",
        "certification_date": "2025-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "MI",
            "license": "4703109056",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "NV",
            "license": "878975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wayne R Elliott
• Zakariyyaa A Elliott
• Ellis Bandt Birkin Kollins & Wong PLLC (Desert Radiology)
• Lurline Veineta Ellis-Boothe
• Alisa Ellis, LMSW, CSW-INTERN
• Alyssa Marie Ellis
• Amanda Ellis
• Amber C Ellis, CPC-INTERN
• Anuttiya Ellis
• Austin Ellis

• Licensed Practical Nurse in Las Vegas, NV
• Providers in Las Vegas, NV by specialty
• Licensed Practical Nurse in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2025; 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.