Andrea Ellis
Technician, Attendant Care Provider in Jackson, MS. Individual provider (NPI-1).
NPI number1376216861
StatusActive
Last updated in NPPESJul 29, 2021
Details
- NPI
- 1376216861
- Entity type
- Individual (NPI-1)
- Name
- Andrea Ellis
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Jul 29, 2021
- Certification date
- Jul 29, 2021
- Last updated
- Jul 29, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 3747A0650X | Technician, Attendant Care Provider | – | – | Yes |
Practice location
4144 Del Rosa DrJackson, MS 39206-4732
Phone 601-572-5631
Mailing address
4144 Del Rosa DrJackson, MS 39206-4732
Phone 601-572-5631
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All 12 Attendant Care Provider providers in Jackson · All 8,702 providers in Jackson
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