Jennifer Hicks Ellerbe, MS
Technician, Other in Grayson, GA. Individual provider (NPI-1).
NPI number1841007283
StatusActive
Last updated in NPPESDec 17, 2024
Details
- NPI
- 1841007283
- Entity type
- Individual (NPI-1)
- Name
- Jennifer Hicks Ellerbe
- Credential
- MS
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Dec 17, 2024
- Certification date
- Dec 17, 2024
- Last updated
- Dec 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 247200000X | Technician, Other | 199759 | GA | Yes |
Practice location
1344 Swallows WalkGrayson, GA 30017-1736
Phone 770-364-2623
Mailing address
1344 Swallows WalkGrayson, GA 30017-1736
Phone 770-364-2623
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