Organization · Type 2 NPI
Dan Ellis GNP Inc
Gerontology Nurse Practitioner · Port Gibson, MS
NPI number
1942552732
Active
Practice location
703B Farmer St
Port Gibson, MS 39150-2319
Fax (601) 629-9969
Mailing address
PO Box 215
Utica, MS 39175-0215
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Gerontology Nurse Practitioner Primary | 363LG0600X | R826981 (MS) |
Gerontology Nurse Practitioner: Definition to come...
2 other providers at this address
About NPI 1942552732
Dan Ellis GNP Inc's National Provider Identifier is 1942552732, issued on Oct 4, 2012. The primary taxonomy on file is Gerontology Nurse Practitioner (363LG0600X), and the practice location is in Port Gibson, MS. The record was last updated on Dec 26, 2012.