Individual provider · Type 1 NPI

Jawaneka P. Ellerson, AG NPC

Gerontology Nurse Practitioner · Montgomery, AL

NPI number 1396276127 Active

Practice location

2900 Mcgehee Rd
Montgomery, AL 36111-2151

Call (334) 280-3349 Map

Fax (334) 281-2308

Mailing address

PO Box 11087
Montgomery, AL 36111-0087

Specialties and licenses

Taxonomy	Code	License
Gerontology Nurse Practitioner Primary	363LG0600X	AG0117043 (AL)

Gerontology Nurse Practitioner: Definition to come...

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About NPI 1396276127

Jawaneka P. Ellerson, AG NPC's National Provider Identifier is 1396276127, issued on Mar 23, 2017. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Montgomery, AL. The record was last updated on Mar 23, 2017.