Most Relevant Information
Provider Data
| NPI Number: | 1003017328 |
| Provider Name: | PEARL ELLIS |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 28162156A |
Most Important Dates
| Enumeration Date: | 05/31/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
2250 HICKORY RD
SUITE 240
PLYMOUTH MEETING
PA
194621047
Practice Location Phone/Fax
| Phone: | 6108341122 |
| Fax: |
Provider Mailing Location
5225 W 36TH CT
INDIANAPOLIS
IN
462241409
Provider Mailing Phone/Fax
| Phone: | 3172808138 |
| Fax: |