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SHANA M ELLIS CRNP

Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1164938544

Individual Registrant:
 SHANA M ELLIS CRNP
Gender: F
Not Sole Proprietor

Location and contact information for practice:
29810 AL HIGHWAY 71  BRYANT, AL 35958-5240 US
Tel: 256-597-2135  Fax: 256-597-4115

Contact information for business:
5086 AL HIGHWAY 73  BRYANT, AL 35958-4316 US
Tel: --  Fax: --

Registration Information:
NPI: 1164938544
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
AL1-145902

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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