Ellis, Jessica Danielle

Ellis, Jessica Danielle is an individual health care provider with primary practice located at 571 S Allen Rd , Flat Rock NC 28731-9447. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Ellis, Jessica Danielle can be contacted via phone (828) 692-6178.

Contact Information

Primary practice address
571 S Allen Rd Flat Rock NC 28731-9447
Phone: (828) 692-6178
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 174165 North Carolina
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 174165 North Carolina

Profile Details

NPI number 1245659705
LBN Legal business name Ellis, Jessica Danielle
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 14th, 2014
Last updated Aug 17th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245659705 NPPES
South Carolina MEDICAID NP2800
South Carolina MEDICAID 1245659705

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