Provider Demographics
NPI:1215599931
Name:ELLIS, MEGAN (DOULA)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:
Last Name:ELLIS
Suffix:
Gender:F
Credentials:DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2800 TODKILL TRCE
Mailing Address - Street 2:
Mailing Address - City:EDGEWOOD
Mailing Address - State:MD
Mailing Address - Zip Code:21040-3429
Mailing Address - Country:US
Mailing Address - Phone:443-619-9527
Mailing Address - Fax:
Practice Address - Street 1:2800 TODKILL TRCE
Practice Address - Street 2:
Practice Address - City:EDGEWOOD
Practice Address - State:MD
Practice Address - Zip Code:21040-3429
Practice Address - Country:US
Practice Address - Phone:443-619-9527
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-02
Last Update Date:2019-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula