HARLEY LYELL ELLIS RN CNP NPI 1568536142

NPI Information

  • NPI: 1568536142
  • Provider Name: HARLEY LYELL ELLIS, RN, CNP
  • Classification: Nurse Practitioner - 363LF0000X
  • Specialization: Family
  • Entity Type: Individual
  • Address: 11855 STATE AVE
    C.O.R.E. BRAINERD
    BRAINERD, MN
    ZIP 56401
  • Phone: (218) 828-2389

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NPI Details

Harley Lyell Ellis, RN, CNP is a family nurse practitioner in Brainerd, MN. Harley Lyell Ellis, RN, CNP NPI is 1568536142. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11855 STATE AVE
C.O.R.E. BRAINERD
BRAINERD, MN
ZIP 56401-127
Phone: (218) 828-2389
Fax: (218) 828-6165

The enumeration date for this NPI number is 11/17/2006 and was last updated on 7/8/2007.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LF0000XNurse PractitionerFamilyR 092367-9MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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