Ellzey, Bonnie Elizabeth

Ellzey, Bonnie Elizabeth is an sole proprietor health care provider with primary practice located at 201 Stateline Rd W Ste 5A , Southaven MS 38671-1600. She recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Medical-Surgical, Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adult Medicine, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Ellzey, Bonnie Elizabeth can be contacted via phone (662) 253-8959.

Contact Information

Primary practice address
201 Stateline Rd W Ste 5A Southaven MS 38671-1600
Phone: (662) 253-8959
Fax: (662) 470-6918
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Medical-Surgical 163WM0705X 902486 Mississippi
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 904198 Mississippi
Allopathic & Osteopathic Physicians / Adult Medicine 207QA0505X 904198 Mississippi
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 904198 Mississippi

Profile Details

NPI number 1972129609
LBN Legal business name Ellzey, Bonnie Elizabeth
Credentials FNP-C
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 18th, 2020
Last updated Jun 24th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1972129609 NPPES
Tennessee Other 30309 TN BOARD OF NURSING
Tennessee Other 904198 TN BOARD OF NURSING

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