Most Relevant Information
Provider Data
| NPI Number: | 1003465428 |
| Provider Name: | LATOYA ELLIS |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | 4704233922 |
Most Important Dates
| Enumeration Date: | 09/09/2019 |
| Last Updated: | 11/14/2022 |
Provider Practice Location
5452 FORT ST STE 200
TRENTON
MI
481834638
Practice Location Phone/Fax
| Phone: | 7346422727 |
| Fax: |
Provider Mailing Location
1663 SAVANNAH CT
YPSILANTI
MI
481983681
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |