Ellis, Jessica Danielle
Ellis, Jessica Danielle is an individual health care provider with primary practice located at 571 S Allen Rd , Flat Rock NC 28731-9447. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Ellis, Jessica Danielle can be contacted via phone (828) 692-6178.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | 174165 | North Carolina |
Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | 174165 | North Carolina |
Profile Details
NPI number | 1245659705 |
---|---|
LBN Legal business name | Ellis, Jessica Danielle |
Credentials | |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Apr 14th, 2014 |
Last updated | Aug 17th, 2022 - about 2 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.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245659705 | NPPES |
South Carolina | MEDICAID | NP2800 | |
South Carolina | MEDICAID | 1245659705 |
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