Angela Ellis, RDN, CD, CLC
Dietitian, Registered in Milwaukee, WI. Individual provider (NPI-1).
NPI number1982241808
StatusActive
Last updated in NPPESDec 10, 2019
Details
- NPI
- 1982241808
- Entity type
- Individual (NPI-1)
- Name
- Angela Ellis
- Credential
- RDN, CD, CLC
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Dec 10, 2019
- Certification date
- Dec 10, 2019
- Last updated
- Dec 10, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133V00000X | Dietitian, Registered | 1057668 | – | Yes |
Practice location
2555 N Dr Martin Luther King Jr DrMilwaukee, WI 53212-2709
Phone 414-267-6655
Mailing address
2555 N Dr Martin Luther King Jr DrMilwaukee, WI 53212-2709
Phone 414-267-6655
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