Provider Demographics
NPI:1659506665
Name:MCGILLIS/BURTON, ELLEN FRANCES I (RN)
Entity Type:Individual
Prefix:MRS
First Name:ELLEN
Middle Name:FRANCES
Last Name:MCGILLIS/BURTON
Suffix:I
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:38850 COUNTRY CIR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48331-1021
Mailing Address - Country:US
Mailing Address - Phone:248-661-5987
Mailing Address - Fax:248-661-5987
Practice Address - Street 1:38850 COUNTRY CIR
Practice Address - Street 2:
Practice Address - City:FARMINGTON HILLS
Practice Address - State:MI
Practice Address - Zip Code:48331-1021
Practice Address - Country:US
Practice Address - Phone:248-661-5987
Practice Address - Fax:248-661-5987
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-19
Last Update Date:2009-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI4704065387163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse