| Doctor Name: | MELISSA KAYE ELLIS EL |
| NPI Number: | 1588965123 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | B.A.,M.S. |
| License Number: | |
| Business Practice Address: | 810 Kempsville Rd Ste.2 Virginia Beach, VA - 234642723 |
| Business Phone Number: | 7574951451 |
| Business Fax Number: | 8666672490 |
| Mailing Address: | 810 Kempsville Rd, Ste.2 VIRGINIA BEACH |
| State: | VA |
| Postal Code: | 234642723 |
| Phone Number: | 7574951451 |
| Fax Number: | 8666672490 |
| NPI Enumeration Date: | 11/13/2010 |
| NPI Last Update Date: | 07/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 171000000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Military Health Care Provider |
| Taxonomy Specialization: | |
| Taxonomy Definition: | Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |