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Contact Information

NOELLE ELLIS, MD
13980 NORTHDALE BLVD
ROGERS, MN55374-2147
 Phone: 763-428-1920
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for NOELLE ELLIS · (Female)

NPI Number 1376805770
Status Active
Credentials MD
Entity Individual
Enumeration date 06/12/2012
Last updated 07/21/2022 - About 4 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 113046
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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