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TAMARA F ELLIS NURSE PRAACTITIONER

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

Registrant NPI Number: 1699385344

Individual Registrant:
 TAMARA F ELLIS NURSE PRAACTITIONER
Gender: F
Not Sole Proprietor

Location and contact information for practice:
163 PUTNAM COUNTY BLVD  EAST PALATKA, FL 32131-6061 US
Tel: 386-538-1285  Fax: --

Contact information for business:
163 PUTNAM CO BLVD P.O. BOX 362 EAST PALATKA, FL 32131-4006 US
Tel: 386-538-1285  Fax: --

Registration Information:
NPI: 1699385344
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y363LF0000XPhysician Assistants & Advanced Practice Nursing Providers
Nurse Practitioner
Family
FLAPRN11010826
N163W00000XNursing Service Providers
Registered Nurse
FLRN9233624

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




HEALTH CARE JOBS FL - Page 1



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