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: |