Most Relevant Information
Provider Data
| NPI Number: | 1003028390 |
| Provider Name: | SANDRA HUDDLESTON ELLIS RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163WC1500X |
| Specialty: | Registered Nurse |
| License Number: | RN0000092176 |
Most Important Dates
| Enumeration Date: | 05/07/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
201 DOOLEY ST SE
CLEVELAND
TN
373116220
Practice Location Phone/Fax
| Phone: | 4237287020 |
| Fax: | 4234796130 |
Provider Mailing Location
3632 STEEPLE CHASE LN NE
CLEVELAND
TN
373235742
Provider Mailing Phone/Fax
| Phone: | 4234763058 |
| Fax: |