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Contact Information

GAYLE M ELLIS
700 RAY O VAC DR
SUITE 220
MADISON, WI53711-2479
 Phone: 608-276-9191
 Fax: 608-276-9144
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Psychiatric/Mental Health

163WP0808X
 

Clinical

103TC0700X 62 Psychologist, Clinical
 

Psychiatric/Mental Health

363LP0808X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for GAYLE M ELLIS · (Female)

NPI # 1295890259
Status Active
Credentials
Entity Individual
Enumeration date 12/27/2006
Last updated 09/11/2025 - About 9 months ago
Sole proprietor 1 No
Identifiers
  • WI License # 1526-033
  • WI License # 2432-057
  • WI Medicaid 3914300
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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