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TAMARA F ELLIS NURSE PRAACTITIONER
Family >> Nurse Practitioner >> Physician Assistants & Advanced Practice Nursing ProvidersRegistrant NPI Number: 1699385344
Individual Registrant: TAMARA F ELLIS NURSE PRAACTITIONER
Gender: F
Not Sole Proprietor
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: --
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: --
Tel: 386-538-1285 Fax: --
Registration Information:
NPI: 1699385344
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 363LF0000X | Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Family | FL | APRN11010826 |
| N | 163W00000X | Nursing Service Providers Registered Nurse | FL | RN9233624 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
