Most Relevant Information
Provider Data
NPI Number: | 1003289950 |
Provider Name: | JESSICA LYNN ELLIS LPN |
Entity Type: | Individual |
Taxonomy Code: | 164W00000X |
Specialty: | Licensed Practical Nurse |
License Number: | 323515-1 |
Most Important Dates
Enumeration Date: | 11/01/2015 |
Last Updated: | 11/01/2015 |
Provider Practice Location
414 LINDEN PL
ELMIRA
NY
149011622
Practice Location Phone/Fax
Phone: | 6074255874 |
Fax: |
Provider Mailing Location
414 LINDEN PL
ELMIRA
NY
149011622
Provider Mailing Phone/Fax
Phone: | 6074255874 |
Fax: |