Ellis, Jerome L
Ellis, Jerome L is an individual health care provider with primary practice located at 1050 Jabarrah Ave Seymour Johnson Afb, Goldsboro NC 27531-2310. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Ellis, Jerome L can be contacted via phone (919) 722-0928.Contact Information
Primary practice address
1050 Jabarrah Ave Seymour Johnson Afb
Goldsboro NC 27531-2310
Phone: (919) 722-0928
Fax: (919) 722-1952
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | C004119 | North Carolina |
Profile Details
| NPI number | 1023008638 |
|---|---|
| LBN Legal business name | Ellis, Jerome L |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2005 |
| Last updated | Jan 22nd, 2009 - about 15 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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