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STEVEN ELLISON NURSE PRACTITIONER

Adult Health >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing Providers

Registrant NPI Number: 1437605219

Individual Registrant:
 STEVEN  ELLISON NURSE PRACTITIONER
Gender: M
Not Sole Proprietor

Location and contact information for practice:
HIGHWAY 264, MP 388  POLACCA, AZ 86042-4000 US
Tel: 928-737-6000  Fax: --

Contact information for business:
PO BOX 4000 HIGHWAY 264, MP 388 POLACCA, AZ 86042-4000 US
Tel: 928-737-6000  Fax: --

Registration Information:
NPI: 1437605219
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LA2200XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Adult Health
FLARNP9220581

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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