Mireille F Ellis, PA is a
Dietitian, Registered based in Alpharetta, Georgia. Mireille F Ellis is licensed to practice in Georgia (license number 001471) and her current practice location is
2650 Holcomb Bridge Rd Ste 510, Alpharetta, Georgia. She can be reached at her office (for appointments etc.) via phone at
(404) 255-4080.
NPI number for Mireille F Ellis is 1154442200 and her current mailing address is 5835 Lenox Park Pl, Buford, Georgia. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1154442200.
Provider's Profile
| Full Name | Mireille F Ellis |
|---|
| Gender | Female |
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| Speciality | Dietitian, Registered |
|---|
| Location | 2650 Holcomb Bridge Rd Ste 510, Alpharetta, Georgia |
|---|
| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1154442200
- Provider Enumeration Date: 04/03/2007
- Last Update Date: 04/19/2023
Medical Identifiers
Medical identifiers for Mireille F Ellis such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1154442200 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 363A00000X | Physician Assistant | 6652 (Georgia) | Secondary |
| 133V00000X | Dietitian, Registered | 001471 (Georgia) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mireille F Ellis is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Mireille F Ellis, PA
5835 Lenox Park Pl,
Buford, GA 30518-7690
Ph: (602) 684-4682 | Mireille F Ellis, PA
2650 Holcomb Bridge Rd Ste 510,
Alpharetta, GA 30022-5374
Ph: (404) 255-4080 |
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