Ellis, Jessica Dyanne

Ellis, Jessica Dyanne is an sole proprietor health care provider with primary practice located at 800 E Main St , Locust Grove OK 74352-5184. She recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as her primary health care specialty. Ellis, Jessica Dyanne can be contacted via phone (918) 479-4815.

Contact Information

Primary practice address
800 E Main St Locust Grove OK 74352-5184
Fax: (918) 479-4817
Website:

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Pharmacist 183500000X 15269 Oklahoma

Profile Details

NPI number 1659976546
LBN Legal business name Ellis, Jessica Dyanne
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 1st, 2020
Last updated Dec 1st, 2020 - about 4 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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