Ellis, Tisha Kim
Ellis, Tisha Kim is an sole proprietor health care provider with primary practice located at 1650 Cochrane Cir , Fort Carson CO 80913-4613. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, which is considered as her primary health care specialty. Ellis, Tisha Kim can be contacted via phone (719) 526-0175.Contact Information
Primary practice address
1650 Cochrane Cir
Fort Carson CO 80913-4613
Phone: (719) 526-0175
Fax: (719) 526-2452
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health | 363LP0808X | 113116 | Nebraska |
Profile Details
| NPI number | 1164058723 |
|---|---|
| LBN Legal business name | Ellis, Tisha Kim |
| Credentials | APRN, PMHNP-BC |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 16th, 2020 |
| Last updated | Oct 20th, 2023 - about last year |
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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