Tisha Kim Ellis, APRN, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Fort Carson, CO. Individual provider (NPI-1).
NPI number1164058723
StatusActive
Last updated in NPPESAug 8, 2025
Details
- NPI
- 1164058723
- Entity type
- Individual (NPI-1)
- Name
- Mrs. Tisha Kim Ellis
- Credential
- APRN, PMHNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Mar 16, 2020
- Certification date
- Aug 8, 2025
- Last updated
- Aug 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | 113116 | NE | Yes |
Practice location
1650 Cochrane CirFort Carson, CO 80913-4613
Phone 719-526-0175 · Fax 719-526-2452
Mailing address
1650 Cochrane CirFort Carson, CO 80913-4613
Phone 719-526-0175 · Fax 719-526-2452
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