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MISS JESSICA ERIN ELLIS R.N.

>> Registered Nurse >> Nursing Service Providers

Registrant NPI Number: 1356529358

Individual Registrant:
MISS JESSICA ERIN ELLIS R.N.
Gender: F
Not Sole Proprietor

Location and contact information for practice:
500 BETHANY WOODS DR  TEMPLE, GA 30179-3574 US
Tel: 205-902-4928  Fax: --

Contact information for business:
306 PELHAM ST  CHICKASAW, AL 36611-2410 US
Tel: 205-902-4928  Fax: --

Registration Information:
NPI: 1356529358
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y163W00000XNursing Service Providers
Registered Nurse
GARN189320
N163W00000XNursing Service Providers
Registered Nurse
AL1-107940

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS GA - Page 1



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