Provider Demographics
NPI:1790425759
Name:ELLIS, NATALIE ANN HARRIS (MD)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:ANN HARRIS
Last Name:ELLIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 E MOUNTAIN VIEW RD APT 603
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-1278
Mailing Address - Country:US
Mailing Address - Phone:931-261-5182
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE CIR # 3712
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710-4000
Practice Address - Country:US
Practice Address - Phone:931-261-5182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-29
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program