Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gretta Ellis

Individual provider Allergy & Immunology Physician · NPI 1457826281

Gretta Ellis is a Nurse Practitioner in Tavares, Florida. Qualified in 2018, 8 years ago. Practices as a sole proprietor, accepts Medicare assignment and offers telehealth. Licensed in Florida.

Years since qualifying
8
Licensed in
FL
In the registry since
2018
Specialties on file
3

Practice location Address checks out

1865 Nightingale Ln Ste B
Tavares, FL 32778-4322
Phone: (352) 508-5419
Fax: (352) 609-2519
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence APRN9327255 (FL)
Allergy & Immunology Physician Taxonomy 207K00000X · Licence APRN9327255 (FL)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 9327255 (FL)

Record details

NPI number1457826281
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 8, 2018
Last updated in NPPESAugust 20, 2021
Certification dateAugust 20, 2021
Mailing address1865 Nightingale Ln, Tavares, FL 32778-4360

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Tavares